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4&$&+G-,+ H(&$3 BR<C<RSTBRSUB V BUWRTBERCSC V BRUDDRCSERXWW V <RWSXRXESRWXB V DRSWCRE<<RUUC V <DRBEDRCBSRCS< V BBRTXBRUUBRSWX V <RBWSRS<WRX<< V S<RCSCRDETRU<D V
;-1&6-%& H(&$3 <<RTBTRDUU V BRETWRSUC V WRCCERUUS V BTRSCBRWDS V SERS<CRSTX V <SBRWCXRXSE V B<SRXDURDCC V <<RTDCRCTW V BWWRE<CRCS< V
8owl e (100) XRWWXRTWS V 2,112,466 $ 2,664,797 $ 29,248,340 $ S<RT<SRSSE V 79,364,402 $ <BERXESR<SB V ER<SURSBX V 172,331,278 $
lrankl l n (100) EDXRUWU V 133,978 $ 326,373 $ - $ SBXRUEU V 6,837,670 $ <CRTTTREBE V X<DREDE V 14,864,498 $
Lamar (100) SRDUCREBX V 99,320 $ 4,491,033 $ 34,303 $ DRUDURSUX V 37,034,086 $ UTRUEXRUUX V SRSBTRUWB V 80,308,868 $
8ed 8l ver (100) WDUR<XS V 432,383 $ 323,127 $ - $ UBUR<BE V 9,370,480 $ <URSTURTWU V WXCRDDB V 20,803,387 $
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+G-,+ H(&$3 <RCCDREE< ERX<URCWXRESS V BTBRWWERTU< V ERTCERTEDRXWD V UUCR<WT <RUCCRDTURSWD V EXTRSBURUEX V BRBXTRWBCRTXC V <CR<EERETURXDD V
;-1&6-%& H(&$3 TRSDW ECRWU<RSXW V BREBURCUS V ESRUEXRDB< V SRD<D TRS<<RWE< V DREEDRSSC V <DRCWXRBC< V WERXXBRXBB V
8owl e (100) 3,387 42,340,327 $ 1,628,474 $ DSRTXWRWC< V 2,011 3,483,243 $ 2,812,363 $ WRBTERXCX V UBRBXXRDCE V
lrankl l n (100) 481 3,647,847 $ 140,302 $ SREWWR<DT V 204 336,363 $ 283,338 $ WD<RTB< V DRXSCRCEC V
Lamar (100) 2,607 19,737,414 $ 739,901 $ BCRU<ERS<D V 974 2,633,671 $ 1,361,601 $ DRC<ERBEB V BDRUSDRUWX V
8ed 8l ver (100) 674 3,103,781 $ 196,376 $ URSCBR<UE V 223 614,393 $ 313,008 $ TBTRDC< V XRBS<RUUW V
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!"#$% &' )*++,- <QDCRQECR U .+/012 3 4/5*5/1*4 3 */066/5*6 3 TQTERQR<V U .7/4*./25* 3 RSQCC<QCTS U <QCVTQVES U 6./067/.56 3
!8&9 )*++,- TQEDDQCW< U *.7/77. 3 0/155/*22 3 ./5*+/210 3 CCQRVVQCWE U 14/.72/01+ 3 CBCQEDSQEDW U TQWVWQTRD U *45/722/15* 3
:;& <;&=9 )*++,- RQETWQW<S U 445/.2* 3 405/006 3 > 3 RVEQVVT U 47/+.7/1+0 3 TDQERTQ<<R U RQBTSQBC< U 54/211/6.1 3
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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;-1&6-%& M(&$3 HNQQS DONHDDNBBP R <NOSONHOD R DPNGDBNHQO R GNO<D SNGOGNBO< R ONPSBNGC< R CONCGGNGQO R HCNOSON<BH R
Popkl ns (100) 1,711 12,970,792 $ 498,877 $ CGNODSNDDH R 733 1,999,034 $ 1,024,933 $ GNB<GNSDP R CDNOSGNDGQ R
PunL (100) 4,432 33,743,337 $ 1,297,821 $ GQNBOCNCQP R 1,732 4,779,388 $ 2,430,461 $ PN<<SNHOS R O<N<PCNBBP R
van ZandL (100) 2,393 18,131,879 $ 698,149 $ CHNHQBNB<H R 940 2,364,620 $ 1,314,918 $ GNHPSNQGP R <<NP<SNQDQ R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 3 - kepresentat|ve Cec|| 8e||, Ir.
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 1S,070,2S1 5 894,893 5 9,311,197 5 3,742,849 5 13,0S4,046 5 6S,42S,42S 5 10S,249,S67 5 S,882,130 5 142,229,160 5
!"#$%"&'() +,-./ 12,387,22S 5 ,01210- 3 021452-06 3 72-1,2014 3 12,234,634 5 1821782458 3 74,702,844 5 4,174,9S2 5 59924142099 3
:;< < '( +599./ 2,683,026 5 8592198 3 054215, 3 = 3 819,412 5 5024002694 3 30,S46,723 5 1,707,179 5 152,-42789 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 3 - kepresentat|ve Cec|| 8e||, Ir.
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 4,60S 34,903,98S 5 1,342,461 5 36,246,446 5 2,436 6,644,S01 5 3,406,731 5 10,0S1,232 5 46,297,678 5
MonLgomery (27) 3,269 24,773,734 $ 932,837 $ 2S,726,S91 5 1,728 4,711,300 $ 2,413,634 $ 7,127,1S4 5 32,8S3,746 5
Wal l er (100) 1,337 10,130,230 $ 389,624 $ 10,S19,8SS 5 709 1,933,001 $ 991,077 $ 2,924,078 5 13,443,933 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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4&$&+G-,+ H(&$3 BRDCDRSTBRSUB V BUWRTBERCSC V BRU<<RCSERXWW V DRWSXRXESRWXB V <RSWCREDDRUUC V D<RBE<RCBSRCSD V BBRTXBRUUBRSWX V DRBWSRSDWRXDD V SDRCSCR<ETRUD< V
;-1&6-%& H(&$3 DDRXT<RSSC V DRXUCRETX V WRDSXRCDD V DCRWBDRSDD V DWRTUERSBB V ESRECDRWUB V DDWRUXSRWDX V XRXBXRBSC V DXCRBBDRSTC V
!"#$"%&'# )*+,- <RSWERDSB V ./.01/+ 2 30*/401/* 2 510*450+55 2 DEREDSR<CT V 6+0/570353 2 ECRXUCRCUT V SRT<WR<UB V /.067+013+ 2
89:;<9# )511,- ERSCERDTE V 501..0716 2 5046+0/5+ 2 = 2 DRB<SRTDS V 4/07*604+3 2 <ERTDSREUE V BRXEEREEW V 36076*0+4* 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ 2$0%+ @((,+0
9(:0&A
BCDE F,:3&1
GDHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
GBCCJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 DPCC<PQQD QPEDRPCIEPQHH S BTBPIIQPTRD S QPTCQPTQ<PEI< S RRCPDIT DPRCCP<TRPHI< S QETPHBRPRQE S BPBETPIBCPTEC S DCPDQQPQTRPE<< S
;-1&6-%& O(&$3 RPDII HTPHDTPHTI S DPRDBPBIR S <CPIHDPEIH S BP<RT EPQCRPDDB S HP<HQPICQ S DCPD<BPTDT S RCPTQ<PECB S
Penderson (83) 3,091 23,429,727 $ 901,143 $ B<PHHCPIQC S 1,162 3,168,043 $ 1,624,302 $ <PQTBPH<Q S BTPDBHPBDQ S
kaufman (100) 2,097 13,889,672 $ 611,141 $ DEPRCCPIDH S 1,297 3,337,067 $ 1,813,303 $ RPHRCPRQH S BDPIRDPHIR S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ @6A$0 7:58+1
9(:0&A
BCDE=BCDF G+H
2(%$3 I$/
>+?+0:+ JK,:3&
./#$01-(0L
BCDD 9(:0&A
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
BCDD I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&AQ9(:0&A
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
BCDC I(&$3
7(1#-&$3 98$6-&A
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&A 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
BCDE=BCDF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
BCDE=BCDF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
BCDE=BCDF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
BCDE=BCDF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 BSDCDSTUBST<B V B<WSUBFSCTC V BS<EESCTFSXWW V DSWTXSXFTSWXB V ESTWCSFDDS<<C V DESBFESCBTSCTD V BBSUXBS<<BSTWX V DSBWTSTDWSXDD V TDSCTCSEFUS<DE V
;-1&6-%& I(&$3 DDSTBTSDCT V TSXBFSCBB V FSBTBS<XT V BTSEXUSBXD V TCSFCDSWBE V DCTSTE<SWDT V DXXSB<DSUDT V USBUDSTUX V BBESXXESFFD V
!"#$ &'(()* WFUSCB< V +,--.,/01 2 +,0/0,+31 2 3,01-,(44 2 FST<USTEX V 4,+-1,-3/ 2 DESWXCSCFF V WTCSEUB V +(,(/','/1 2
56778 9 &'(()* UT<SU<F V '-',04- 2 '1+,1(( 2 : 2 DFBSFCC V '(,(1-,((( 2 DXSBCESTWF V UC<SXBB V +',/41,/+- 2
;"8 <9 &'(()* XUXSTC< V ''(,.+/ 2 '+1,'(1 2 : 2 DBFSDCF V 1,(+-,44/ 2 DDSBUUSEFB V XTDSEUU V '.,+04,../ 2
=#8 >? &+3)* ESCTCS<TW V 1/',/-0 2 444,.0' 2 '/,140,'0+ 2 DUSFU<SFBT V +1,-3(,40( 2 ETSUWTSBFD V BSE<WSDDT V .4,3-0,/.4 2
@8 >A9 &'(()* DSUUTSDUD V ./,(14 2 +,003,/3. 2 : 2 BSXXESWE< V ++,44',1-0 2 TXSUWXSXUX V BSCXFSCUB V 34,4/+,(+1 2
B66C &'(()* BSFWWSCWF V +(4,('/ 2 ./+,'(- 2 : 2 <WBSDCT V +0,01/,11( 2 EBSUDWSCDC V BSTUWS<FW V .1,441,-'1 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ @6A$0 7:58+1
9(:0&A
BCDE F,:3&1
GDHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
GBCCJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 DPCCQPRRD RPED<PCIEPRHH S BTBPIIRPT<D S RPTCRPTRQPEIQ S <<CPDIT DP<CCPQT<PHIQ S RETPHB<P<RE S BPBETPIBCPTEC S DCPDRRPRT<PEQQ S
;-1&6-%& O(&$3 RPBR< <<PDHQPBHQ S BPDBCP<QR S <RPB<QPRID S HPQCH TPBICPBHC S QPR<IPDCR S DQPCHIPHHR S RDPBTHPDDT S
Camp (100) 630 4,928,037 $ 189,341 $ <PDDRP<TI S 308 838,741 $ 430,033 $ DPBEIPRRE S EPHIEPHRQ S
Morrl s (100) 709 3,373,872 $ 206,687 $ <P<ICP<<T S 239 706,263 $ 362,112 $ DPCEIPHRR S EPEQIPTHR S
8al ns (100) 494 3,747,231 $ 144,123 $ HPITDPHRR S 176 479,867 $ 246,034 $ RB<PTCD S QPEDRPBRR S
Sml Lh (24) 1,923 14,386,202 $ 361,008 $ D<PDQRPBDC S 1,033 2,870,936 $ 1,471,970 $ QPHQBPTCE S DTPQTCPDDE S
1l Lus (100) 1,618 12,263,923 $ 471,766 $ DBPRHRPEIT S 962 2,623,270 $ 1,344,988 $ HPTEIPB<T S DEPRC<PTQI S
Wood (100) 1,878 14,232,929 $ 347,420 $ DQPRICPHQT S 646 1,761,131 $ 902,967 $ BPEEQPDDT S DRPQQQPQEI S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ *$&& 4%8$+)+6
9(:0&@
ABCD=ABCE F+G
2(%$3 H$/
>+?+0:+ IJ,:3&
./#$01-(0K
ABCC 9(:0&@
!0,-5+0&
7+$3&8%$6+ L
M06+-"N:61+,
O$-3 7+$3&8%$6+
9(1&1
ABCC H(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&@P9(:0&@
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
ABCB H(&$3
7(1#-&$3 98$6-&@
9$6+ 9(1&1
H(&$3
M06+-"N:61+,
98$6-&@ 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
ABCD=ABCE J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
ABCD=ABCE J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
ABCD=ABCE
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
ABCD=ABCE J,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+G-,+ H(&$3 ARCBCRSTARSUA V AUWRTAERBSB V ARUDDRBSER<WW V CRWS<R<ESRW<A V DRSWBRECCRUUB V CDRAEDRBASRBSC V AART<ARUUARSW< V CRAWSRSCWR<CC V SCRBSBRDETRUCD V
;-1&6-%& H(&$3 CARTEDR<U< V ARUC<RWBB V SRACER<E< V <BRUB<RUBD V <SREADRCWB V WWRBCART<A V CDCRUW<RBSB V ERTCARWWS V CTCRSSARDTS V
!"# $% '()*+ CARTEDR<U< V ,-./)-011 2 3-,/(-)() 2 )1-.1)-.14 2 <SREADRCWB V 00-1/,-5), 2 CDCRUW<RBSB V ERTCARWWS V /5/-33,-453 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ *$&& 4%8$+)+6
9(:0&@
ABC< D,:3&1
ECFGH IJ2
.06(33++1
*(,+6$&+
4%+0$6-(
ABC< D,:3&1
I+,+6$3 I:0,1
*(,+6$&+
4%+0$6-(
ABC< D,:3&1
4&$&+ I:0,1
*(,+6$&+
4%+0$6-(
ABC< D,:3&1
D33 I:0,1
*(,+6$&+
4%+0$6-(
ABC< 98-3,6+0
EABBH IJ2
.06(33++1
*(,+6$&+
4%+0$6-(
ABC< 98-3,6+0
I+,+6$3 I:0,1
*(,+6$&+
4%+0$6-(
ABC< 98-3,6+0
4&$&+ I:0,1
*(,+6$&+
4%+0$6-(
ABC< 98-3,6+0
D33 I:0,1
*(,+6$&+
4%+0$6-(
ABC< D,:3&1 K
98-3,6+0
D33 I:0,1
*(,+6$&+
4%+0$6-(
4&$&+L-,+ M(&$3 CNBBONPPC PN<CQNBG<NPFF R ASANGGPNSQC R PNSBPNSPON<GO R QQBNCGS CNQBBNOSQNFGO R P<SNFAQNQP< R ANA<SNGABNS<B R CBNCPPNPSQN<OO R
;-1&6-%& M(&$3 <NCSQ O<NSQONAPC R CNGBQNSFF R OGNP<BNABO R FNFGS SNAOCNPSP R ONPFGNOBA R CFNSGBNCSS R <ANPOBNOBF R
Sml Lh (76) 6,193 46,934,271 $ 1,803,933 $ OGNP<BNABO R 3,389 9,241,797 $ 4,738,402 $ CFNSGBNCSS R <ANPOBNOBF R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ ;$?-, 4-"#1(0
9(:0&@
ABCD=ABC< E+F
2(%$3 G$/
>+?+0:+ HI,:3&
./#$01-(0J
ABCC 9(:0&@
!0,-5+0&
7+$3&8%$6+ K
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9(1&1
ABCC G(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&@O9(:0&@
L06+-"M:61+,
7+$3&8%$6+
./#+0,-&:6+1
ABCB G(&$3
7(1#-&$3 98$6-&@
9$6+ 9(1&1
G(&$3
L06+-"M:61+,
98$6-&@ 9$6+
9(1&1 )(6 2(%$3
N:6-1,-%&-(01 K
7(1#-&$31
ABCD=ABC< I,:3&1
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2-"-&+,
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ABCD=ABC< I,:3&1
P+,+6$3 P:0,1
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ABCD=ABC<
I,:3&1 4&$&+
P:0,1 *(,+6$&+
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ABCD=ABC< I,:3&1
P+,+6$3 P:0,1
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4&$&+F-,+ G(&$3 AQCBCQRSAQRTA U ATVQSA<QBRB U AQTDDQBR<QWVV U CQVRWQW<RQVWA U DQRVBQ<CCQTTB U CDQA<DQBARQBRC U AAQSWAQTTAQRVW U CQAVRQRCVQWCC U RCQBRBQD<SQTCD U
;-1&6-%& G(&$3 CRQWTTQARA U AQRDTQVWD U RQCDDQ<TA U ACQBSTQASB U ADQADBQBDA U CAWQTSTQ<BW U ABRQWTRQSBW U CCQRVCQWSV U A<TQABVQBCB U
!"#$$ &'(()* CBQVBSQTBS U +,('+,-'+ . +,/0',/1+ . +',(23,+2( . ARQVT<QBRA U 2-,23/,(03 . CTSQCSCQ<TW U VQVSWQVAA U +'3,'+1,('/ .
45678" &'(()* AQVDTQ<AR U 999,(39 . 9-9,('' . : . RVRQBCC U +/,09-,01+ . DDQDWAQCTB U AQDVDQV<W U 0(,(-9,229 .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ ;$?-, 4-"#1(0
9(:0&@
ABCD E,:3&1
FCGHI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1
E33 J:0,1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
FABBI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1 L
98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 COBBPO<<C <ODCQOBHDO<GG R ASAOHH<OSQC R <OSB<OS<PODHP R QQBOCHS COQBBOPSQOGHP R <DSOGAQOQ<D R AOADSOHABOSDB R CBOC<<O<SQODPP R
;-1&6-%& N(&$3 HOSCC D<OQG<OHHA R AOQS<ODCC R <BOCGQOPSG R GOQGD SODPPOBHD R POSPPODDA R CPOQHHO<PH R HPO<APOAPC R
Cregg (100) 6,966 32,792,869 $ 2,030,493 $ QPOHAGOGDP R 2,803 7,644,232 $ 3,919,308 $ CCOQDGOQPB R DDOGHDOSBQ R
upshur (100) 1,946 14,743,013 $ 367,116 $ CQOGCAOCAS R 733 1,999,834 $ 1,023,334 $ GOBAQOABH R CHOGG<OGGD R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ @A6(0 9((B
9(:0&A
CDEF=CDEG H+I
2(%$3 J$/
>+?+0:+ KL,:3&
./#$01-(0M
CDEE 9(:0&A
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7+$3&8%$6+ N
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9(1&1
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7(1#-&$31
CDEF=CDEG L,:3&1
S+,+6$3 S:0,1
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4%+0$6-(
CDEF=CDEG L,:3&1
S+,+6$3 S:0,1
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CDEF=CDEG
L,:3&1 4&$&+
S:0,1 *(,+6$&+
4%+0$6-(
CDEF=CDEG L,:3&1
S+,+6$3 S:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 CTEDETUVCTUWC X CW<TVCGTDUD X CTWFFTDUGTY<< X ET<UYTYGUT<YC X FTU<DTGEETWWD X EFTCGFTDCUTDUE X CCTVYCTWWCTU<Y X ETC<UTUE<TYEE X UETDUDTFGVTWEF X
;-1&6-%& J(&$3 EDTUGUTDCU X ETWV<TUGW X FTYCVTDEG X CTDDVTWEG X YTYU<TWUF X ECVTDCVTCYC X CDGTWY<TGWW X EETYDDTF<V X C<DTFV<TUFG X
!"#$%&'" )*++,- UTFEET<WF X *./01+2 3 4++0./. 3 451062+ 3 ETD<GTVCY X 4701.20**. 3 <<TEDYT<EF X FTVCFTDYY X **20+./0614 3
8%$$&9'"$ )*++,- ETCVUT<FD X *46065* 3 *05+*0//+ 3 : 3 ET<DETUUD X *4064.0/+7 3 CFTWFCTGFF X ETUGETYUE X //0*.4051/ 3
;< = = )*++,- CTU<WTUF< X 1210+/6 3 21/0++* 3 .+50611 3 ETW<ETCG< X 6/071*0.16 3 UGTGW<TGYY X CTEEDTCFE X 4*0+640/.4 3
>?@?%%' )*++,- UTC<ETV<E X 7540/4/ 3 *0/470+4+ 3 5*/024+ 3 CTEY<TDDD X /404/60*1+ 3 WGTEYDTFUE X UTEVFTWWE X 11067/05/7 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ @A6(0 9((B
9(:0&A
CDEF G,:3&1
HEI<J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
K+,+6$3 K:0,1
*(,+6$&+
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CDEF G,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
G33 K:0,1
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CDEF 98-3,6+0
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4&$&+ K:0,1
*(,+6$&+
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CDEF 98-3,6+0
G33 K:0,1
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CDEF G,:3&1 M
98-3,6+0
G33 K:0,1
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4&$&+N-,+ O(&$3 EPDDQPRRE RPFESPD<FPRII T CUCP<<RPUSE T RPUDRPURQPF<Q T SSDPE<U EPSDDPQUSPI<Q T RFUPICSPSRF T CPCFUP<CDPUFD T EDPERRPRUSPFQQ T
;-1&6-%& O(&$3 UPD<I F<P<IFPEFF T CPFQRPSQS T REPQ<IPREE T IPCIQ <P<CDPSCD T QPSCCPQD< T EIPIQCPUC< T <QP<CFPFIU T
Anderson (100) 3,833 29,218,922 $ 1,123,803 $ IDPIQCPRCR T 967 2,637,213 $ 1,332,138 $ IPU<UPISI T IQPIICPD<D T
lreesLone (100) 1,074 8,139,127 $ 313,043 $ <PQSCPERD T 381 1,040,121 $ 333,283 $ EPSRIPQDF T EDPDCSPSRF T
Pl l l (100) 1,632 12,321,963 $ 481,614 $ EIPDDIPSRU T 712 1,940,793 $ 993,073 $ CPUISP<FF T ESPUIUPQQS T
navarro (100) 2,301 18,936,132 $ 729,083 $ EUPF<SPCIS T 1,174 3,202,391 $ 1,641,912 $ QP<QQPIDI T CQPSCUPSI< T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ 986-1 @$,,-+
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BCDE=BCDF K,:3&1
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R:0,1 *(,+6$&+
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BCDE=BCDF K,:3&1
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4&$&+H-,+ I(&$3 BSDCDST<BSTUB V BUWS<BFSCTC V BSUEESCTFSXWW V DSWTXSXFTSWXB V ESTWCSFDDSUUC V DESBFESCBTSCTD V BBS<XBSUUBSTWX V DSBWTSTDWSXDD V TDSCTCSEF<SUDE V
;-1&6-%& I(&$3 DBSXDTSXET V BSCW<SWTE V USCUESCDW V TSFUESDWB V WSWCWSBCC V DBWSWCTSEDC V BCFSBCUSEBW V DDSUWCSDWE V BWCSCCFSTXU V
!"## %&''() BSCWWSFT< V *+',-*. / 0+*,+-1 / &,'+-,2.. / DSETDSET< V **,3-+,'3' / TXS<FFSXDT V BSCXXSUWU V 13,3+3,2.* /
4"556 #78 %&''() USEFBSXT< V 2'-,2.0 / &,1.0,3.& / *,+-.,1*2 / ESDT<STFW V .0,.*+,30' / WXSDCWSUDX V ESWDBSTWX V &&+,0+*,-2& /
9"56 78 %&''() XXXS<<< V 1,''' / *'3,+*. / : / BC<SXBU V -,11+,-++ / DTSUWWSETB V FU<SEBT V &-,0+*,21- /
;"87< " %&''() DS<BTSWUX V 03+,301 / &,&22,-1' / : / DSDFFSWEC V &-,'-.,&'& / B<SC<TSEDU V DSXBUS<UF V 03,0&.,10' /
=">6 8? %&''() FDDSBEB V *,3+* / &,'&-,+-1 / : / DSCDWSXWE V +,2-+,-.0 / DCS<DFS<FW V XDCSDFW V &1,2.1,'*2 /
=@?< >A %&''() DSFUCSDXW V 2&+,0+' / -0&,*0. / : / WTDSBTU V &-,32&,.2' / TCSUD<SEFE V DSFCUSXUX V 1&,*1*,.02 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& < = >+#6+1+0&$&-?+ 986-1 @$,,-+
9(:0&A
BCDE F,:3&1
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BCDE F,:3&1
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BCDE 98-3,6+0
GBCCJ K@2
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BCDE F,:3&1 L
98-3,6+0
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*(,+6$&+
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4&$&+M-,+ N(&$3 DOCCPOQQD QOEDROCIEOQHH S B<BOIIQO<RD S QO<CQO<QPOEIP S RRCODI< DORCCOP<ROHIP S QE<OHBRORQE S BOBE<OIBCO<EC S DCODQQOQ<ROEPP S
;-1&6-%& N(&$3 <OCEQ EIOQDROEQE S BOEPBO<DD S QDOHRIORIE S HOPC< <OB<QODCE S POQEEOQEC S DPOCEHOIEE S IROPBBOPRB S
Cass (100) 1,618 12,262,911 $ 471,630 $ DBOQHPORED S 387 1,602,016 $ 821,377 $ BOPBHOH<B S DRODRQO<RH S
Parrl son (100) 3,768 28,336,223 $ 1,098,316 $ B<OERPORPD S 1,448 3,948,830 $ 2,024,632 $ RO<QHOPIB S HROEBIOCBP S
Marl on (100) 393 4,306,341 $ 173,321 $ POEQ<OEEB S 166 432,797 $ 232,136 $ EIPO<RH S ROHEPOEDR S
anol a (100) 1,273 9,648,269 $ 371,087 $ DCOCD<OHRE S 471 1,283,743 $ 638,193 $ DO<PDO<PC S DDO<EDOB<E S
Sabl ne (100) 478 3,620,737 $ 139,239 $ HOQR<O<<E S 134 420,396 $ 213,343 $ EHRO<H< S POH<RO<HR S
Shel by (100) 1,333 10,121,194 $ 389,277 $ DCORDCOPQC S 383 1,389,301 $ 814,838 $ BOPCPODR< S DBO<DPOEHC S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.








!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-" B-&&1
9(:0&C
D=<E>D=<F G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
D=<< 9(:0&C
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D=<E>D=<F K,:3&1
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4&$&+H-,+ I(&$3 DR<=<RSTDRSUD V DUWRTDFR=S= V DRUEER=SFRXWW V <RWSXRXFSRWXD V ERSW=RF<<RUU= V <ERDFER=DSR=S< V DDRTXDRUUDRSWX V <RDWSRS<WRX<< V S<R=S=REFTRU<E V
;-1&6-%& I(&$3 <<RWSXREUE V DRXS<RF=S V ERETTRTXF V DRETURDEE V XRTTURD<< V UDRDXFR<<U V WER=W<RWUF V ERXTTR<D< V <<SRXDER<ES V
!" " # $ &'(()* <=RTDTRUUU V +,-(.,/.0 1 2,(0-,+30 1 +-.,+.3 1 SRSSSRUS< V 32,'..,--3 1 XTREFFRD<T V SRWWDRT=U V 42,...,'33 1
567869$:7 &'0)* T=XRWTT V '+2,('/ 1 ',3+3,0+' 1 +,+2/,4/( 1 SRXX<RXW= V 4,(0.,-/' 1 <ERX=ERXSW V W<XRD<X V '4,02/,((( 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-" B-&&1
9(:0&C
D=<E F,:3&1
G<HIJ KB2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
GD==J KB2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1 L
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 <O==POQQ< QOE<RO=IEOQHH S DTDOIIQOTR< S QOT=QOTQPOEIP S RR=O<IT <OR==OPTROHIP S QETOHDRORQE S DODETOID=OTE= S <=O<QQOQTROEPP S
;-1&6-%& N(&$3 HOEQT DQOIIPO<DH S <O=QDOPEE S DIOTREORIT S DOH=T EODTQOEH= S HODDIOIIR S TORDEOR<R S HIOPIHO<=P S
Ll l l s (100) 3,040 23,040,777 $ 886,184 $ DHOTDEOTE< S 2,069 3,642,738 $ 2,893,113 $ IORHROIR< S HDOPEDOI<< S
Penderson (17) 639 4,843,346 $ 186,283 $ RO=DTOEDT S 240 634,892 $ 333,772 $ TT=OEEP S EO=D=ODTH S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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789%:;%9"#< ()**+, DQCWRQVRW U = 2 5035-0.-6 2 3064305)6 2 <DQT<VQDDV U 3/0-)30116 2 VEQB<WQWWR U DQVEDQR<E U ))105.*04.5 2
>?<& ()**+, RQREDQVRT U /)50/53 2 3)/0/5/ 2 /04410/3/ 2 DQVT<QSRV U /406.-0*61 2 ECQEB<QW<D U RQSTBQDT< U 6303.60136 2
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ @6$?-1 93$6,A
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4&$&+M-,+ @(&$3 <NCCONPP< PND<QNCHDNPGG R BSBNHHPNSQ< R PNSCPNSPONDHO R QQCN<HS <NQCCNOSQNGHO R PDSNGBQNQPD R BNBDSNHBCNSDC R <CN<PPNPSQNDOO R
;-1&6-%& @(&$3 SNDCQ PBNPSONBPD R BNPSSNPHC R PQNQSONCQD R GNDOS SNSQ<NBHG R QN<CBN<DD R <QNCQGNOOS R SCNDOPNQCO R
Cherokee (100) 2,694 20,417,098 $ 783,273 $ B<NBCBNGP< R 1,182 3,223,719 $ 1,632,847 $ ONHPDNQDQ R BDNCPHNSGP R
nacogdoches (100) 3,816 28,923,721 $ 1,112,431 $ GCNCGDN<PB R 1,419 3,870,103 $ 1,984,237 $ QNHQONGDC R GQNHSCNQGB R
8usk (100) 3,093 23,433,437 $ 902,036 $ BONGQQNQ<G R 1,048 2,837,461 $ 1,463,062 $ ONGBBNQBG R BHNDPHNCGD R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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;-1&6-%& H(&$3 <CRWWTR<UX V =RT=DRU<W V <CRCXWRDW< V <SRESWR=XD V =SRWCXREDU V <DDRCTDR=WT V =S<RWCSRET= V <=RTUDRT=D V S<SR=DWRDC< V
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7#8 8 & ()11+, <RCDERSE< V .*)04.3 2 --.05*1 2 9 2 SS=RUXC V )505160/6. 2 =DRTD=RDCS V <RSTSRTXE V --0/150356 2
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@A:=??#? (-1+, UR<SDRDWU V )0*-50))/ 2 .0.3/035- 2 )10-.405*3 2 <=RX=XRU=< V 5/0/360*-- 2 T=RTESRTDT V UR<TXRCEE V ).50*61064* 2
B%C=">&%? ()11+, <R=STRSDX V )*6063/ 2 ./60-56 2 9 2 =EDRSUD V ).04/-05*5 2 =CRECTRXDS V <R<UERDCT V ./034*011/ 2
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ N(&$3 <OCCPOQQ< QOD<ROCHDOQGG S =T=OHHQOTR< S QOTCQOTQPODHP S RRCO<HT <ORCCOPTROGHP S QDTOG=RORQD S =O=DTOH=COTDC S <CO<QQOQTRODPP S
;-1&6-%& N(&$3 <CO<PG QDOHQGO=PH S =OTRDODDG S QTOH=TOT<< S GORRC TODH<O<RR S POTDGODDQ S <PODPPOH== S TPOPQPOQGG S
8razos (16) 2,788 21,131,836 $ 812,764 $ =<OTPPOD=C S 603 1,630,311 $ 846,138 $ =OPTDOPRC S =POPP<OCQC S
lal l s (100) 1,091 8,271,666 $ 318,141 $ HORHTOHCQ S 367 1,001,368 $ 313,318 $ <OR<ROCHD S <CO<CPOHTG S
Ll mesLone (100) 1,289 9,768,739 $ 373,722 $ <CO<PPOPH< S 302 1,369,463 $ 702,144 $ =OCQ<OD<C S <=O=<DOCTC S
McLennan (30) 4,068 30,833,014 $ 1,183,883 $ G=OC<HOHTT S 1,694 4,620,100 $ 2,368,792 $ DOTHHOHT< S GTOCCQOQTC S
8oberLson (100) 906 6,867,933 $ 264,132 $ QO<G=O<CR S 381 1,039,711 $ 333,073 $ <ORQ=OQHR S HOQCPOHTC S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 13 - kepresentat|ve Lo|s W. ko|khorst
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 13,S3S,208 5 1,378,123 5 11,423,8S4 5 2,668,264 5 14,092,118 5 123,947,S91 5 199,393,896 5 11,143,617 5 269,4S1,239 5
!"#$% & ()**+, 2,362,602 5 )-*.)/0 1 ).23-.0-0 1 4 1 1,S47,272 5 0*.50).*56 1 32,690,3S3 5 1,826,981 5 33.)-6.)2/ 1
7"89 :#;& ()**+, 1,2S0,760 5 )*.52- 1 ).0<-.62) 1 4 1 1,297,6S1 5 )0.5/-.</3 1 19,928,490 5 1,113,7S3 5 06.<5*.5<3 1
=;9 ;8>?; ()**+, 1,662,933 5 )-3.*)< 1 0.<60.30* 1 5</.<3- 1 3,361,367 5 )3.-/-.66) 1 23,788,840 5 1,329,498 5 50.)3-.*/3 1
@>A:$$: ()**+, 2,007,366 5 5/3.<2- 1 0.)53.<<- 1 5//.66< 1 2,S23,666 5 )6.)3/.30* 1 2S,977,88S 5 1,4S1,838 5 52.)*2.023 1
B8% C:# ()**+, 1,691,842 5 006.6)< 1 6-2.3-) 1 3)/.</0 1 1,094,4S3 5 0).<20./)- 1 3S,31S,391 5 1,973,687 5 3-.-05.2*- 1
D>E>F> ()**+, 1,491,S49 5 32.536 1 ).63).-<< 1 //2.<53 1 2,S27,733 5 )0.30)./6) 1 19,982,989 5 1,116,798 5 0-.**3.*30 1
G>#H% &I$;& ()**+, 3,068,1SS 5 566.635 1 ).)63.032 1 2-2.-50 1 1,739,977 5 02.<0-./)0 1 41,709,948 5 2,331,063 5 26.563./** 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 13 - kepresentat|ve Lo|s W. ko|khorst
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 8,72S 66,12S,132 5 2,S43,274 5 68,668,406 5 3,474 9,47S,S18 5 4,8S8,234 5 14,333,7S2 5 83,002,1S9 5
AusLl n (100) 1,430 10,841,124 $ 416,966 $ 11,2S8,090 5 626 1,708,243 $ 873,841 $ 2,S84,083 5 13,842,173 5
8url eson (100) 872 6,608,899 $ 234,188 $ 6,863,087 5 349 931,120 $ 487,633 $ 1,438,773 5 8,301,860 5
Col orado (100) 1,041 7,889,109 $ 303,427 $ 8,192,S36 5 461 1,237,906 $ 644,947 $ 1,902,8S3 5 10,09S,389 5
layeLLe (100) 1,137 8,613,064 $ 331,349 $ 8,946,412 5 460 1,234,213 $ 643,034 $ 1,897,269 5 10,843,682 5
Crl mes (100) 1,343 11,711,667 $ 430,449 $ 12,162,116 5 343 1,480,204 $ 738,922 $ 2,239,12S 5 14,401,241 5
Lavaca (100) 874 6,626,972 $ 234,884 $ 6,881,8S6 5 364 992,344 $ 308,892 $ 1,S01,436 5 8,383,292 5
Washl ngLon (100) 1,823 13,832,298 $ 332,011 $ 14,364,310 5 671 1,831,283 $ 938,926 $ 2,770,212 5 17,134,S21 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
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Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
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Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
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Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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O:6-1,-%&-(01 L
7(1#-&$31
DE<F>DE<= J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
DE<F>DE<= J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
DE<F>DE<=
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
DE<F>DE<= J,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ A(&$3 DR<E<RSTDRSUD V DUWRTD=RESE V DRUFFRES=RXWW V <RWSXRX=SRWXD V FRSWER=<<RUUE V <FRD=FREDSRES< V DDRTXDRUUDRSWX V <RDWSRS<WRX<< V S<RESERF=TRU<F V
;-1&6-%& A(&$3 TRTXDRX<W V DRWEERDFS V =RD<URF== V UEREEE V =RDXURF== V <DXRU<<RE<D V DESRU<=RXUW V <<RS=FREWF V D=UREDSRWTD V
!"#$%&' )*++,- FRFX<RTFE V *./01.213 4 5.20*.+36 4 1+.+++ 4 DRUS<REX= V 11.6*5.+20 4 WTRXDSR=EU V UREEWRWF< V *5*.**7.*50 4
8"9 :;<9 9 )*++,- DREWFR=F< V 2/*.*+2 4 *.*+*.*63 4 = 4 <R<E<R<=X V 50.*03.777 4 FURSFSRD<W V DRUSFR<<= V 3*.562.353 4
>&?@"9 <# )*++,- <RSSERUEE V 5.0+1 4 *.6*/./31 4 = 4 <R=<TRTXU V *3.+37.651 4 DURWF<RXSW V <RFFFRDDS V 72./5*.*73 4
A"%?<# )*++,- WSFREFX V = 4 *.777.631 4 = 4 <RSSSR=XU V *2./*6.153 4 DSRTT=R=US V <RSF<R<=S V 75.25/.7// 4
B<< )*++,- <RDU<RSTE V 75+.060 4 16/.1+1 4 = 4 U=TRUEU V **.37*.76/ 4 <WR=<<RSFF V <REFUR=DT V 51.501.3+7 4
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-" B3+-01%8"-,&
9(:0&C
DE<F G,:3&1
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.06(33++1
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*(,+6$&+
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L+,+6$3 L:0,1
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4&$&+ L:0,1
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*(,+6$&+
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DE<F G,:3&1 N
98-3,6+0
G33 L:0,1
*(,+6$&+
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4&$&+O-,+ A(&$3 <PEEQP==< =PF<RPEJFP=II S DTDPJJ=PTR< S =PTE=PT=QPFJQ S RREP<JT <PREEPQTRPIJQ S =FTPIDRPR=F S DPDFTPJDEPTFE S <EP<==P=TRPFQQ S
;-1&6-%& A(&$3 JPTER F=PQTDPFTJ S DPRTRPJ=I S =EPEJJPR=< S IPTTR <EPJTFPFF< S RPRJFPJ=R S <FPQJIPRIF S JFPR=DP<E= S
8asLrop (100) 3,922 29,721,970 $ 1,143,133 $ IEPJFRP<DD S 1,811 4,937,703 $ 2,331,632 $ =PQFTPIIR S IJPIIQPQR= S
Cal dwel l (100) 1,984 13,037,202 $ 378,334 $ <RPF<RPRRF S 1,020 2,782,816 $ 1,426,790 $ QPDETPFER S <TPJDRP<F< S
Conzal es (100) 1,131 8,369,880 $ 329,611 $ JPJTTPQT< S 301 1,367,004 $ 700,883 $ DPEF=PJJ= S <EPTF=PI=J S
karnes (100) 1,030 7,938,391 $ 306,092 $ JPDFQPQJI S 272 742,338 $ 380,617 $ <P<DDPT=R S TPIJ=PQRJ S
Lee (100) 819 6,203,236 $ 238,664 $ FPQQIPT<T S 391 1,066,780 $ 346,934 $ <PF<IP=IQ S JPER=PFRI S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(80 B&&(
9(:0&C
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?+@+0:+ KL,:3&
./#$01-(0M
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7(1#-&$3 98$6-&C
9$6+ 9(1&1
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98$6-&C 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 N
7(1#-&$31
DE<F>DE<G L,:3&1
R+,+6$3 R:0,1
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4&$&+I-,+ J(&$3 DS<E<STUDSTVD W DV=SUDGSETE W DSVFFSETGSX== W <S=TXSXGTS=XD W FST=ESG<<SVVE W <FSDGFSEDTSET< W DDSUXDSVVDST=X W <SD=TST<=SX<< W T<SETESFGUSV<F W
;-1&6-%& J(&$3 <ES=FXSUEE W XX=S<DF W GS=UUST<F W TSUTVSXU= W <<S=TVSE<D W <<XSVVESUT= W <=GSFUFSUTF W <ESFG=SX<V W DVTSTG<SVXE W
!" #$%&' )*++,- VSFXTSUUD W .*+/001 2 34*/51. 2 6 2 =V<SFDT W 10/07+/485 2 F=SD<TSVED W DSXUFSVTE W 84/*4./.33 2
9:; <:=" ;&> )*++,- <SGFFSDDV W 174/1*3 2 .*8/4++ 2 6 2 T<XSVEE W *3/77./04+ 2 TESDE<SVXT W <SX=GS=== W 5+/3*1/017 2
?:@ A$% )*++,- TSXT=SX=F W 3*/0*4 2 8/7.*/.0* 2 ./0.4/803 2 <ESXXGSE=U W 87/3+8/515 2 <EUSEGUS=GE W XSEUXS<UX W *57/5+4/154 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(80 B&&(
9(:0&C
DE<F G,:3&1
H<I=J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
G33 K:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
HDEEJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1 M
98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PEEQPRR< RPF<SPE=FPRII T DUDP==RPUS< T RPUERPURQPF=Q T SSEP<=U <PSEEPQUSPI=Q T RFUPIDSPSRF T DPDFUP=DEPUFE T <EP<RRPRUSPFQQ T
;-1&6-%& O(&$3 =PDEQ FDP<RUPERD T DPIU<PSEI T FQPSREPSRQ T DPSQU FPUS<PEUD T IPSFIPUDS T <EPS<SPE<R T RSPE=SPSU< T
Ll berLy (100) 2,110 13,989,076 $ 614,964 $ <FPFEQPEQ< T 981 2,676,389 $ 1,372,326 $ QPEQ=PU<Q T DEPFSDPUSS T
San !acl nLo (100) 1,322 10,013,763 $ 383,222 $ <EPQEEPU=F T 303 1,371,316 $ 703,196 $ DPERQPR<D T <DPQRSPFU= T
Wal ker (100) 4,773 36,174,231 $ 1,391,317 $ IRPSFSPSQR T 1,064 2,902,987 $ 1,488,403 $ QPIU<PIU< T Q<PUSFPUI= T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$"+1 B8-&+
9(:0&C
DE<F>DE<G H+I
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?+@+0:+ KL,:3&
./#$01-(0M
DE<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ N
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A$-3 7+$3&8%$6+
9(1&1
DE<< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
DE<E J(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 N
7(1#-&$31
DE<F>DE<G L,:3&1
R+,+6$3 R:0,1
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R+,+6$3 R:0,1
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DE<F>DE<G
L,:3&1 4&$&+
R:0,1 *(,+6$&+
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DE<F>DE<G L,:3&1
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4&$&+I-,+ J(&$3 DS<E<ST=DSTUD V DUWS=DGSETE V DSUFFSETGSXWW V <SWTXSXGTSWXD V FSTWESG<<SUUE V <FSDGFSEDTSET< V DDS=XDSUUDSTWX V <SDWTST<WSX<< V T<SETESFG=SU<F V
;-1&6-%& J(&$3 <DSXDFSWFF V <SF=TSG<T V FSE<USETX V > V FSE<USETX V <<WSTWUS=WU V <=ESFFXS=XG V <ESXFTSU=X V DUGSTXESG=T V
!"#$% & ()**+, FSFE<S<TD V -./0./) 1 .--0-2. 1 3 1 UTTSTDU V 2405*.0)66 1 FGSGWXSU=T V DSXGESXG< V /70.5/0767 1
8"9:;# ()**+, DSFUESE=D V .//0*/2 1 4/50/25 1 3 1 =XGSXDG V 2/0/.*0.-4 1 FDSWGDSU=F V DST=XSEFE V .504-.0477 1
<;=>?& ()**+, WDWSXWX V 6406/- 1 )5*045. 1 3 1 <GES=GU V ))075-026- 1 <WSFUGSE<U V <SET<SU<X V 27047)04). 1
@?A B ()**+, TSX<WSTX< V 76)0225 1 /6*0.-- 1 3 1 XWESUTT V -70)5)07)) 1 UFS=G<STWX V TSEGDSD<< V 57026.0//7 1
CDA ;# ()**+, <STDXSUGT V 3 1 )0//20.55 1 3 1 <SXXDSUGG V )/0-6.0./7 1 DXSTU=STG= V <SFGTS<U= V -.0/2*056/ 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$"+1 B8-&+
9(:0&C
DE<F G,:3&1
H<IJK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
G33 L:0,1
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DE<F 98-3,6+0
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.06(33++1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
4&$&+ L:0,1
*(,+6$&+
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DE<F 98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1 N
98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+O-,+ P(&$3 <QEERQSS< SQF<TQEJFQSII U D=DQJJSQ=T< U SQ=ESQ=SRQFJR U TTEQ<J= <QTEEQR=TQIJR U SF=QIDTQTSF U DQDF=QJDEQ=FE U <EQ<SSQS=TQFRR U
;-1&6-%& P(&$3 JQIII FIQ<TJQETF U DQRD=Q<TF U FTQTJSQD<D U DQJ=S SQ=EEQ<F< U RQETEQTDF U <<Q=TEQFJS U SSQTISQJ== U
Pardl n (100) 2,091 13,847,300 $ 609,319 $ <FQRTSQE<= U 827 2,234,962 $ 1,136,132 $ IQR<<Q<<R U <=QJFJQ<II U
!asper (100) 1,876 14,217,867 $ 346,841 $ <RQSFRQSEJ U 702 1,914,934 $ 981,823 $ DQJ=FQSS= U <SQFF<QRJJ U
newLon (100) 808 6,120,912 $ 233,420 $ FQITFQIID U 263 723,081 $ 370,734 $ <QE=IQJ<T U SQRTEQ<RS U
ol k (100) 2,403 18,230,198 $ 701,161 $ <JQ=I<QIT= U 787 2,146,273 $ 1,100,426 $ IQDRFQSE< U DDQ<SJQEFE U
1yl er (100) 1,133 8,741,379 $ 336,213 $ =QESSQS=I U 316 860,889 $ 441,390 $ <QIEDQDS= U <EQIJEQESD U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *$618$ A$60+B
9(:0&B
<=CD><=CE F+G
2(%$3 H$/
?+@+0:+ IJ,:3&
./#$01-(0K
<=CC 9(:0&B
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<=C= H(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
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<=CD><=CE J,:3&1
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<=CD><=CE J,:3&1
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;-1&6-%& H(&$3 C<QSTTQW=V U CQSD=QDCT U TQCDCQV<= U TVSQ=<V U TQER=QVDE U VTQVRSQDDE U CRVQ=VSQT=E U EQECEQDEC U CVWQW=EQDW< U
!"#$%& ()**+, RQW<CQ=SR U -*./011 2 )/340/*0- 2 5 2 CQR<TQ=TW U 41/-*6/1-6 2 DDQD=EQWTC U <QDVCQVRC U -*/*)*/36- 2
78 9 :; ()**+, CQWWSQCTS U 0.)/040 2 )/*../)0- 2 5 2 CQ=SSQCTW U )-/-0*/.6) 2 <WQEVWQ<VV U CQDSEQ=CE U 3-/).1/-.) 2
<8 9 9 8 :;=>$ (44+, EQWWTQRTW U 13./3)3 2 4/1)1/-*? 2 0?./*4? 2 RQR=WQWRW U 6)/0?3/163 2 WWQVSTQTWV U RQERVQW<R U .*/3../640 2
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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4&$&+L-,+ M(&$3 CN==ONPPC PNDCQN=HDNPGG R <S<NHHPNSQC R PNS=PNSPONDHO R QQ=NCHS CNQ==NOSQNGHO R PDSNG<QNQPD R <N<DSNH<=NSD= R C=NCPPNPSQNDOO R
;-1&6-%& M(&$3 DN=O< OQNPSONPCD R CNPDCNGGQ R OPNQQDN=Q< R <NPSG PNDCHNQCP R GNS=DNC<G R CCNQ<ONDO= R QSN=H=NDSC R
8urneL (100) 1,943 14,726,939 $ 366,421 $ CQN<SGNGD= R 770 2,101,139 $ 1,077,294 $ GNCPHNOQO R CHNOPCNHCO R
Ml l am (100) 1,172 8,883,133 $ 341,660 $ SN<<ONHCQ R 381 1,384,380 $ 812,334 $ <NGSDNPCO R CCND<CNQ<S R
Wl l l l amson (22) 2,927 22,184,622 $ 833,233 $ <GN=GPNHPP R 1,442 3,932,978 $ 2,016,494 $ QNSOSNOP< R <HNSHPNGOS R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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;-1&6-%& H(&$3 =RQE=TQCTS U DQESDQSSC U TQERSQESR U VQTDCQTEE U =DQ<VCQREC U ==VQW=WQ=RW U =SCQV=EQ<=C U =CQWWDQ<VV U <TEQVW=Q=<< U
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8$9':" )255,- WQDVRQT<E U 2.*62.64* 1 2.666.70+ 1 2.**+.3*4 1 <QVS<QVCV U /+.6*+.325 1 EDQVWRQTDR U DQ=VRQSRR U 252.2++.7+5 1
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& M(&$3 GNFQC DFN<GCNGOC R <NOFFNGPG R DQNP=ONP=G R FN=QO GNDC=NO<D R ONO=CNCPQ R =FNC==NQCC R PGNP<DN<=S R
!efferson (36) 3,074 38,433,793 $ 1,478,992 $ FSNSF<NPGQ R 1,867 3,091,838 $ 2,610,639 $ PNPC<NOSD R OPNDFQN<G= R
Crange (100) 3,276 24,827,047 $ 934,886 $ <QNPG=NSFO R 1,287 3,309,388 $ 1,799,416 $ QNFCSNCCO R F=NCSCNSFP R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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;-1&6-%& H(&$3 C<QSWCQERD U WQCE<QBDB U EQDSSQBRW U C<QSCCQSRB U <BQDCBQSWW U C<SQCSDQRT< U <BEQVRDQRRD U CCQWCTQRR< U <VBQVTEQ<RS U
!"##"$%&' )*+,- C<QSWCQERD U *./01.2+2 3 0.+44.25* 3 /1.4//.452 3 <BQDCBQSWW U /14./4+.561 3 <BEQVRDQRRD U CCQWCTQRR< U 172.760.154 3
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& N(&$3 TOBTP DHOT<PO<PC S <ODRBOTG< S QCORQROCQG S GOGPD TOC<DORDD S PODQTOG<C S CGOHBROHHQ S HROGHCOBDB S
!efferson (64) 9,094 68,924,241 $ 2,630,932 $ QCORQROCQG S 3,346 9,126,366 $ 4,679,321 $ CGOHBROHHQ S HROGHCOBDB S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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*(,+6$&+
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<BCD E,:3&1 K
98-3,6+0
E33 I:0,1
*(,+6$&+
4%+0$6-(
4&$&+L-,+ M(&$3 CNBBONPPC PNDCQNBGDNP== R <S<NGGPNSQC R PNSBPNSPONDGO R QQBNCGS CNQBBNOSQN=GO R PDSN=<QNQPD R <N<DSNG<BNSDB R CBNCPPNPSQNDOO R
;-1&6-%& M(&$3 ONDQS =QN=C<NSCB R CN=QGNCGS R =DNDPCNBSG R <N=<C DN==CNCQS R =N<ODNBPP R SNQPPN<=D R ODN<OGN==O R
Chambers (100) 946 7,172,191 $ 273,834 $ PNOOGNBOQ R 308 1,384,230 $ 709,713 $ <NBS=NSOQ R SNQOCNSSB R
Cal vesLon (44) 3,713 28,140,718 $ 1,082,333 $ <SN<<=NBQO R 1,814 4,946,929 $ 2,336,362 $ PNOG=N<SC R =DNPBDN=OQ R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A6+5 B(00+0
9(:0&C
<DE=><DEF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
<DEE 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
<DEE I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
<DED I(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
<DE=><DEF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
<DE=><DEF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
<DE=><DEF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
<DE=><DEF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 <SEDESTU<STV< W <VXSU<FSDTD W <SV==SDTFSYXX W ESXTYSYFTSXY< W =STXDSFEESVVD W E=S<F=SD<TSDTE W <<SUY<SVV<STXY W ES<XTSTEXSYEE W TESDTDS=FUSVE= W
;-1&6-%& I(&$3 E=SUD<S=X= W VSY=USFVV W USDF=SFUT W > W USDF=SFUT W YYSFEYST=E W EDFST<YS<VX W VSUUXSEUE W E=VSDTVS=UU W
!"# $%&'() +,-./ E=SUD<S=X= W ,0-1203,, 4 205310326 4 7 4 USDF=SFUT W --038-0618 4 EDFST<YS<VX W VSUUXSEUE W 81,056,0122 4
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A6+5 B(00+0
9(:0&C
<DEF G,:3&1
HEIJK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
<DEF G,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
<DEF G,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
<DEF G,:3&1
G33 L:0,1
*(,+6$&+
4%+0$6-(
<DEF 98-3,6+0
H<DDK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
<DEF 98-3,6+0
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
<DEF 98-3,6+0
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
<DEF 98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
<DEF G,:3&1 N
98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+O-,+ P(&$3 EQDD=QRRE RQFESQDJFQRII T <U<QJJRQUSE T RQUDRQUR=QFJ= T SSDQEJU EQSDDQ=USQIJ= T RFUQI<SQSRF T <Q<FUQJ<DQUFD T EDQERRQRUSQF== T
;-1&6-%& P(&$3 =QFUF ISQSU<QFRU T EQIFJQU=U T IFQUFEQF<J T <Q<U= FQ<SFQU<J T IQ<DJQDER T UQ=F=QU=F T =FQ=<FQSR= T
Cal vesLon (36) 4,696 33,392,679 $ 1,368,949 $ IFQUFEQF<J T 2,294 6,236,928 $ 3,208,017 $ UQ=F=QU=F T =FQ=<FQSR= T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;+00-1 A(00+0
9(:0&B
<CDE><CDF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
<CDD 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
<CDD I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BQ9(:0&B
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
<CDC I(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
<CDE><CDF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
<CDE><CDF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
<CDE><CDF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
<CDE><CDF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 <SDCDSTU<ST=< V <=WSU<FSCTC V <S=EESCTFSXWW V DSWTXSXFTSWX< V ESTWCSFDDS==C V DES<FESC<TSCTD V <<SUX<S==<STWX V DS<WTSTDWSXDD V TDSCTCSEFUS=DE V
;-1&6-%& I(&$3 DTSXF=SFC< V <SCFXS=WX V D=SWWESWXC V DSFFFSWTC V DFSXX<SXUC V WES=CTSFUD V DT=SUECSWET V FS=UFSTWW V DWTSFCTSWX< V
!"#$%"& # ())*+ DDSDEUSEWU V ,-.)/-001 2 1-00,-/,. 2 0-/,,-31, 2 WSXT=SDU< V /1-.43-3)5 2 UDSW=DSDCT V =SDTTST<E V 0,)-0,6-0,3 2
7#8#9%":# (0..*+ <S=<XS<DT V 60-)34 2 5-11,-6). 2 ,//-0/5 2 USC<FSEUW V ,1-).1-0)6 2 EESCWUSFEC V <SEXESCXT V /4-/5.-163 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;+00-1 A(00+0
9(:0&B
<CDE F,:3&1
GDHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
<CDE F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
<CDE F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
<CDE F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
<CDE 98-3,6+0
G<CCJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
<CDE 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
<CDE 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
<CDE 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
<CDE F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 DPCCQPRRD RPED=PCIEPRHH S <T<PIIRPT=D S RPTCRPTRQPEIQ S ==CPDIT DP=CCPQT=PHIQ S RETPH<=P=RE S <P<ETPI<CPTEC S DCPDRRPRT=PEQQ S
;-1&6-%& O(&$3 =PTQI Q=PCI<PD=Q S DPRHHPT<T S QEPIDEPCIH S HPDRD IPEQRP=R< S QPQHHPRH= S DHPCIDPHCR S =TPITRPHTC S
8razorl a (44) 4,019 30,460,643 $ 1,171,363 $ HDPEH<P<CR S 2,222 6,061,213 $ 3,107,672 $ TPDEIPIIR S QCPICDPCTQ S
MaLagorda (100) 1,929 14,621,310 $ 362,366 $ D=PDIHPIRE S 948 2,386,337 $ 1,326,063 $ HPTD<PQ<C S DTPCTEP<TE S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?-%A *-33+6
9(:0&B
<CDE><CDF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
<CDD 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
<CDD I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BQ9(:0&B
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
<CDC I(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
<CDE><CDF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
<CDE><CDF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
<CDE><CDF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
<CDE><CDF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 <SDCDSTU<STV< W <VXSU<FSCTC W <SVEESCTFS=XX W DSXT=S=FTSX=< W ESTXCSFDDSVVC W DES<FESC<TSCTD W <<SU=<SVV<STX= W DS<XTSTDXS=DD W TDSCTCSEFUSVDE W
;-1&6-%& I(&$3 D=S<D=STF= W DSUCVSDVT W ESTCXS<DX W ESX=ESV<X W USDF<SFE= W F<SEFDS<VU W DD=SVXESD=F W =SVDVSVU< W DVFSVE=SDXX W
!"#$ &'() *+,-. D=S<D=STF= W /01230/34 5 604270+/7 5 6078603+7 5 USDF<SFE= W ,+06,/0+31 5 DD=SVXESD=F W =SVDVSVU< W /3,03680/77 5
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?-%A *-33+6
9(:0&B
<CD= E,:3&1
FDGHI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
<CD= E,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
<CD= E,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
<CD= E,:3&1
E33 J:0,1
*(,+6$&+
4%+0$6-(
<CD= 98-3,6+0
F<CCI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
<CD= 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
<CD= 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
<CD= 98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
<CD= E,:3&1 L
98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 DOCCPOQQD QO=DROCH=OQGG S <T<OHHQOTRD S QOTCQOTQPO=HP S RRCODHT DORCCOPTROGHP S Q=TOG<RORQ= S <O<=TOH<COT=C S DCODQQOQTRO=PP S
;-1&6-%& N(&$3 RODCD GHO==<OHH= S DOPHQOCGP S PCODPTOT<C S <OH<G QOQCCODT< S GOTPQOTTT S DDO=PHODTD S RDOQTHODDD S
lorL 8end (27) 3,101 38,662,886 $ 1,487,034 $ PCODPTOT<C S 2,823 7,700,192 $ 3,947,999 $ DDO=PHODTD S RDOQTHODDD S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?(0 ?+A0(3,1
9(:0&A
<BCD><BC= E+F
2(%$3 G$/
?+@+0:+ HI,:3&
./#$01-(0J
<BCC 9(:0&A
!0,-5+0&
7+$3&8%$6+ K
L06+-"M:61+,
N$-3 7+$3&8%$6+
9(1&1
<BCC G(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&AO9(:0&A
L06+-"M:61+,
7+$3&8%$6+
./#+0,-&:6+1
<BCB G(&$3
7(1#-&$3 98$6-&A
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
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Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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F? G@9"? # '())*+ FSEXXS=D< V -;4.544 1 ;.--;./)- 1 /.,2,.0,; 1 WS<DCSDTU V 40.,;).2/5 1 FUSEWDSDTT V ESCDWSEUC V ();.))(.0-( 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ N(&$3 DO==POQQD QOEDRO=HEOQ<< S CTCOHHQOTRD S QOT=QOTQPOEHP S RR=ODHT DOR==OPTRO<HP S QETO<CRORQE S COCETOHC=OTE= S D=ODQQOQTROEPP S
;-1&6-%& N(&$3 QOD=T R<OHQQOCH< S CO=QCOC=< S RROTPTOPHE S <O<=H TO=C=OEQ= S POECRO=CQ S D<OEPROETQ S ETORTRODH< S
Aransas (100) 1,088 8,247,368 $ 317,214 $ HOREPOQHC S 363 994,183 $ 309,733 $ DOR=<OTDH S D=O=EHOQ== S
Cal houn (100) 810 6,133,974 $ 233,999 $ EO<QDOTQ< S 462 1,238,727 $ 643,367 $ DOT=PO=TP S HOCQEO=EQ S
ueWl LL (100) 1,131 8,369,880 $ 329,611 $ HOHTTOPTD S 377 1,028,227 $ 327,187 $ DORRROPD< S D=OPRPOT=P S
Col l ad (100) 369 2,793,377 $ 107,313 $ COT=COHTC S 137 372,409 $ 190,940 $ RE<O<PT S <OPEEOCPD S
8efugl o (100) 409 3,096,603 $ 119,100 $ <OCDROQ=< S 163 444,184 $ 227,740 $ EQDOTCP S <OHHQOECQ S
vl cLorl a (100) 3,303 23,031,881 $ 962,763 $ CROTTPOEPR S 1,803 4,922,938 $ 2,324,061 $ QOPPEOTTT S <<OPPDOEPR S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!"#$%&$# ()**+, CSWECSED= V -./01-2 3 10)440561 3 7 3 ES=CCSUTE V 2.06--0.42 3 UTSEWUSFCE V <S<CESUDX V /*02/.0)42 3
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I# J#> > E ()**+, <E=SXTT V 4*605)/ 3 26*046* 3 7 3 <TDSCTD V -04-/0*/4 3 ==SFDWSC=U V XUES<EC V )50/4)06)1 3
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J"#99 ()**+, CSEXDSUED V )1-0224 3 10./1066) 3 21.0562 3 USD<=SUWE V 550-5-04)6 3 WTSXTXS<FD V USD=CSTDC V )4)04))0241 3
M@ > > #%H ()**+, =SCDCSD=X V )560.5* 3 1440441 3 7 3 ECCSCCE V 44022)0))6 3 <USTC<STXE V CSDDFSXTT V 1/051506*2 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?A$0 B:-33+0
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4&$&+M-,+ N(&$3 =ODDPOQQ= QOE=RODHEOQ<< S CTCOHHQOTR= S QOTDQOTQPOEHP S RRDO=HT =ORDDOPTRO<HP S QETO<CRORQE S COCETOHCDOTED S =DO=QQOQTROEPP S
;-1&6-%& N(&$3 =DOHT< HCORRQOD== S <O=QROCQD S HROQ<COCHD S ROCHD =POPDDORDQ S QO<H<O<PQ S C=OQH<OHRP S =DQOR=EO=<P S
ALascosa (100) 2,603 19,727,291 $ 738,742 $ CDOPHEOD<< S 1,239 3,380,393 $ 1,733,176 $ RO==<ORET S CRORTTOEDC S
8rooks (100) 433 3,432,030 $ 132,771 $ <ORHPOHC= S 221 602,499 $ 308,910 $ T==OPDT S POPTEOC<D S
uuval (100) 773 3,861,838 $ 223,436 $ EODHQO<=P S 334 911,336 $ 467,233 $ =O<QHORT= S QOPEROTDR S
!l m Pogg (100) 344 2,603,603 $ 100,216 $ COQDROHCD S 168 438,129 $ 234,889 $ ET<OD=H S <O<THOH<T S
kenedy (100) 28 213,870 $ 8,226 $ CCCODTE S 10 28,300 $ 14,310 $ PCOH=D S CEPOTDE S
La Sal l e (100) 312 3,882,803 $ 149,339 $ POD<CO=PC S 162 440,903 $ 226,037 $ EEEOTED S POETTO=DC S
Ll ve Cak (100) 644 4,882,874 $ 187,803 $ RODQDOEQE S 193 327,033 $ 270,217 $ QTQOCRD S ROHEQOTCQ S
McMul l en (100) 36 271,103 $ 10,427 $ CH=OR<D S 11 29,120 $ 14,930 $ PPODRD S <CRORH= S
SLarr (100) 3,923 29,746,068 $ 1,144,080 $ <DOHTDO=PQ S 2,290 6,246,037 $ 3,202,443 $ TOPPHORD= S PDO<<HOEPH S
Wl l l acy (100) 1,372 11,913,488 $ 438,211 $ =CO<Q=OQDD S 631 1,776,736 $ 910,938 $ COEHQOETR S =RODRTO<TP S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!"#$#% '()*+ D<R=SVRET< U ,-.,-/ 0 ,/.1/2./12 0 34.5)1.1/1 0 EDR=WWR<=T U ,3).34,.--, 0 =CFRVSERFCF U DDRWDVRFCW U 3-2.)4-.-3( 0
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ A(&$3 DNCCONPPD PNEDQNCHENP<< R =S=NHHPNSQD R PNSCPNSPONEHO R QQCNDHS DNQCCNOSQN<HO R PESN<=QNQPE R =N=ESNH=CNSEC R DCNDPPNPSQNEOO R
;-1&6-%& A(&$3 SNCSP EHNSOON=E= R =NEQDNPC= R PDNQSQNSEO R <NPS< DCN<OON<HH R QN<C<NPDE R DQNEOHNDCO R HPN=OONCEH R
nueces (49) 9,097 68,944,262 $ 2,631,702 $ PDNQSQNSEO R 3,793 10,344,388 $ 3,303,716 $ DQNEOHNDCO R HPN=OONCEH R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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4&$&+H-,+ @(&$3 BRDCDR<SBR<TB U BTVRSBFRC<C U BRTEERC<FRWVV U DRV<WRWF<RVWB U ER<VCRFDDRTTC U DERBFERCB<RC<D U BBRSWBRTTBR<VW U DRBV<R<DVRWDD U <DRC<CREFSRTDE U
;-1&6-%& @(&$3 DVRESTRVDC U DRVBTRVC< U BR<<BREF< U = U BR<<BREF< U TDRTSFRS<C U V<RCCTR<EB U ERW<VRSTF U DDBRDWSR<S< U
!"# # $ % '()*+ DCRBDERECV U ,(-./)0 1 (.2,3.30( 1 4 1 DRCV<R<FD U )-./33.,)2 1 EFRWFDRFVE U BRWWERBTT U /5.5)(.330 1
6"789:# # '(22*+ VRBVDRECB U (.22/.(0; 1 (.)5-.(2) 1 4 1 DRBESRDCB U )(.-/5.(2- 1 <TR<<<RTTV U DRSFERFC< U 50.05,.2;/ 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ 4%(&& @:60+6
9(:0&A
BCDE F,:3&1
GD<HI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1
F33 J:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
GBCCI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
BCDE 98-3,6+0
F33 J:0,1
*(,+6$&+
4%+0$6-(
BCDE F,:3&1 L
98-3,6+0
F33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ @(&$3 DNCCONPPD PNEDQNCHENP<< R BSBNHHPNSQD R PNSCPNSPONEHO R QQCNDHS DNQCCNOSQN<HO R PESN<BQNQPE R BNBESNHBCNSEC R DCNDPPNPSQNEOO R
;-1&6-%& @(&$3 <NE<B BPNQBPNDDP R DNCQHNP<Q R BHNQHQNHQ< R BNDDB QNPQSNBDS R BNSQBNH<Q R HNPDBNCQO R <PNBSPNSCP R
Col l l n (12) 2,086 13,809,426 $ 608,033 $ DENODPNOHD R 1,143 3,116,672 $ 1,397,963 $ ONPDONE<Q R BDND<BNDDE R
8ockwal l (100) 1,346 11,717,692 $ 430,680 $ DBNDEHN<PB R 969 2,642,347 $ 1,334,872 $ <NSSPNODS R DENDEQNPSD R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ AB+3 7+66+6(
9(:0&C
DEF=>DEFG H+I
2(%$3 J$/
?+@+0:+ KA,:3&
./#$01-(0L
DEFF 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"B:61+,
O$-3 7+$3&8%$6+
9(1&1
DEFF J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CP9(:0&C
N06+-"B:61+,
7+$3&8%$6+
./#+0,-&:6+1
DEFE J(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
J(&$3
N06+-"B:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 M
7(1#-&$31
DEF=>DEFG A,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
DEF=>DEFG A,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
DEF=>DEFG
A,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
DEF=>DEFG A,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 DRFEFR<SDR<TD U DTVRSDGRE<E U DRT==RE<GRWVV U FRV<WRWG<RVWD U =R<VERGFFRTTE U F=RDG=RED<RE<F U DDRSWDRTTDR<VW U FRDV<R<FVRWFF U <FRE<ER=GSRTF= U
;-1&6-%& J(&$3 F<RGVDREEE U FVRV=S U FVRDESRW=D U D=RTTGRFG< U =DRGWWRVFT U F<<RS<ERVSS U DFTR=T<RSS= U FDRE=FRFGT U DSFRFT=REGV U
!"#$#% '()*+ F<RGVDREEE U ),-,./ 0 ),-12/-3.1 0 1.-((4-)45 0 =DRGWWRVFT U )55-/52-,// 0 DFTR=T<RSS= U FDRE=FRFGT U 1/)-)(.-24, 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ AB+3 7+66+6(
9(:0&C
DEFG A,:3&1
HF<IJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
DEFG A,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DEFG A,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DEFG A,:3&1
A33 K:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
HDEEJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
A33 K:0,1
*(,+6$&+
4%+0$6-(
DEFG A,:3&1 M
98-3,6+0
A33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 FPEE=PQQF QPGFRPEIGPQ<< S DTDPIIQPTRF S QPTEQPTQ=PGI= S RREPFIT FPREEP=TRP<I= S QGTP<DRPRQG S DPDGTPIDEPTGE S FEPFQQPQTRPG== S
;-1&6-%& O(&$3 TP=DI QFP=RFPFR< S DPQ=IPFDF S Q=PFTTPDQR S <PT<F FEPQDEPRDF S RP=TGPRGG S FGPDFQPEIQ S TEP=FGP<GD S
nueces (31) 9,428 71,431,133 $ 2,748,121 $ Q=PFTTPDQR S 3,931 10,720,321 $ 3,496,366 $ FGPDFQPEIQ S TEP=FGP<GD S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A1%$6 2(05(6-$
9(:0&B
CDEF>CDEG H+I
2(%$3 J$/
?+@+0:+ KL,:3&
./#$01-(0M
CDEE 9(:0&B
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
CDEE J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BR9(:0&B
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
CDED J(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
CDEF>CDEG L,:3&1
S+,+6$3 S:0,1
2-"-&+,
4%+0$6-(
CDEF>CDEG L,:3&1
S+,+6$3 S:0,1
*(,+6$&+
4%+0$6-(
CDEF>CDEG
L,:3&1 4&$&+
S:0,1 *(,+6$&+
4%+0$6-(
CDEF>CDEG L,:3&1
S+,+6$3 S:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 CTEDET<UCT<=C V C=WTUCGTD<D V CT=FFTD<GTXWW V ETW<XTXG<TWXC V FT<WDTGEET==D V EFTCGFTDC<TD<E V CCTUXCT==CT<WX V ETCW<T<EWTXEE V <ETD<DTFGUT=EF V
;-1&6-%& J(&$3 WTDCFTXFC V ETCWUTXDC V <TGEET<EC V E<TUFFTCG< V EGTX==T=W= V E<<TWCUTD<X V CE=TCUDTECW V ECTD<CTDEG V CUDTU<CTX<G V
!"#$%&' )*+,- <T<UWTGEU V ./*01*2 3 *04.50454 3 6012/062/ 3 =TUGCTGW= V 1.0.720114 3 UXTFGETECF V =T<UET=CX V *45047704.+ 3
89 :"; <& )*4,- FTXC=TUC< V 4720526 3 /04/*05*5 3 .047*0+.5 3 EETXWCTWDD V +402750624 3 EEWTWEUTDD= V XTXFDTFUC V *7501770/65 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A1%$6 2(05(6-$
9(:0&B
CDEF G,:3&1
HE<IJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
G33 K:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
HCDDJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1 M
98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 EPDDQPRRE RPFE=PDIFPR<< S CTCPIIRPT=E S RPTDRPTRQPFIQ S ==DPEIT EP=DDPQT=P<IQ S RFTP<C=P=RF S CPCFTPICDPTFD S EDPERRPRT=PFQQ S
;-1&6-%& O(&$3 TPQCD REP<TFPIED S CPRQFPD<E S RQPEQCPIQC S FPRID EIPQTDPQ<R S TPQIDP<E< S CRPTRDPR=D S EDCPEE<P=TC S
Cameron (17) 4,221 31,992,784 $ 1,230,492 $ <<PCC<PCR= S 2,744 7,483,004 $ 3,836,644 $ EEP<ETPFQI S QQP=QCPTC< S
Pl dal go (13) 3,199 39,404,027 $ 1,313,339 $ QDPTETP=FF S 4,036 11,007,433 $ 3,643,670 $ EFPF=EPED< S =RP=RDPFFT S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 36 - kepresentat|ve Serg|o Muoz, Ir.
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 7,838,909 5 623,741 5 3,933,093 5 1S,864,126 5 19,797,219 5 12S,161,107 5 201,346,072 5 11,2S2,720 5 272,089,316 5
!" #$% &' )**+, 7,838,909 5 -*./012 3 ./4../54. 3 26/7-1/2*- 3 19,797,219 5 2*6/2-2/250 3 201,346,072 5 11,2S2,720 5 *0*/574/.2- 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 36 - kepresentat|ve Serg|o Muoz, Ir.
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 8,810 66,772,S34 5 2,S68,174 5 69,340,708 5 6,839 18,6S2,769 5 9,S63,S43 5 28,216,312 5 97,SS7,021 5
Pl dal go (22) 8,810 66,772,334 $ 2,368,174 $ 69,340,708 5 6,839 18,632,769 $ 9,363,343 $ 28,216,312 5 97,SS7,021 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& P(&$3 FEQ<S= =JQRU<QDDF T <QEFJQU=E T JFQSFDQFUF T GQ=<D FJQ<SUQDUU T UQRF<QE== T D=Q==DQ<=S T FEUQDJRQSG= T
Cameron (42) 10,337 78,493,221 $ 3,018,970 $ JFQSFDQFUF T 6,732 18,339,299 $ 9,413,077 $ D=Q==DQ<=S T FEUQDJRQSG= T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& I(&$3 =SBTUSUED V BSBETSBBW V <S<T<SE<C V DDSD=ES=U< V DESUF=SB=< V DEWS<FCS<BF V B<USEWUSBE< V D<SDUTSUU< V <D=SDTWS<C= V
!"#$%&' )*+,- =SBTUSUED V ./.*0/..1 2 3/303/*34 2 ++/+5*/563 2 DESUF=SB=< V +*1/374/3.7 2 B<USEWUSBE< V D<SDUTSUU< V 3+5/+01/345 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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Cameron (41) 10,303 78,087,497 $ 3,003,363 $ =DNCSCN=EB R 6,697 18,264,401 $ 9,364,421 $ BPNEB=N=B< R DC=NPDSNE=Q R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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9(:0&C
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*(,+6$&+
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4&$&+N-,+ O(&$3 FPEEQPRRF RPGFSPEIGPR<< T D=DPIIRP=SF T RP=ERP=RQPGIQ T SSEPFI= FPSEEPQ=SP<IQ T RG=P<DSPSRG T DPDG=PIDEP=GE T FEPFRRPR=SPGQQ T
;-1&6-%& O(&$3 IPR=Q GGPGSDP<=G T DPSG<PSSQ T G=PDFSP=SE T GPIDR FIPGF=PDE= T =PSQGP<<G T DIPFGSPSQS T =RP<IFPQ=S T
Pl dal go (22) 8,794 66,632,396 $ 2,363,334 $ G=PDFSP=SE T 6,827 18,619,209 $ 9,346,336 $ DIPFGSPSQS T =RP<IFPQ=S T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A+66B 9$0$3+1
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!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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Pl dal go (22) 8,793 66,633,381 $ 2,363,399 $ ESOCDPODID R 6,827 18,619,340 $ 9,346,306 $ CIODEEO=<E R SPOHIHOCCP R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!" #$% &' )**+, GSXTFSETT W -*./010 2 ./3*4/560 2 71/46-/1-3 2 =USGGVSTFX W 7*1/0**/141 2 EF=S=ETSETE W ==SE<FSEYY W *57/544/740 2
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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Pl dal go (22) 8,801 66,698,633 $ 2,363,332 $ GVREGJRVGT U 6,832 18,632,123 $ 9,332,939 $ EKR=KTRFK< U VSR<<VRF<V U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!"## %&'() VQRRVQBW< U *+,-&+./- 0 ,+/./+1/* 0 2+&31+&1, 0 CBQVS=QWC< U *.-+&-2+&'. 0 CWSQSDBQSRS U SQ<SSQ=<R U //1+&1.+'3, 0
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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=BCD E,:3&1 L
98-3,6+0
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4&$&+M-,+ N(&$3 COBB<OPPC PODCQOBHDOPGG R =S=OHHPOSQC R POSBPOSP<ODH< R QQBOCHS COQBBO<SQOGH< R PDSOG=QOQPD R =O=DSOH=BOSDB R CBOCPPOPSQOD<< R
;-1&6-%& N(&$3 PO<GP QDOGDPOQPP R =OCDPOSH< R QHOQGQOQDC R DOCS< CDOHS=OG=C R HODDBOSGD R =QOQQGO=QD R H<OBHHOHCP R
Webb (64) 7,437 36,367,377 $ 2,167,984 $ QHOQGQOQDC R 6,194 16,892,321 $ 8,660,936 $ =QOQQGO=QD R H<OBHHOHCP R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 43 - kepresentat|ve I.M. Lozano
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 12,099,169 5 2,1S2,944 5 4,033,363 5 10,177,311 5 14,210,674 5 14S,SS0,338 5 234,146,130 5 13,08S,831 5 316,413,723 5
!"" $%&&'( 1,727,816 5 )%*+,,- . /0%+)1& . 2 . 481,230 5 1)+**-+*-, . S2,373,S97 5 2,927,027 5 3&+33*+%1, .
45 6 7"8 8 9 $%&&'( 3,122,660 5 /3)+0%0 . 0,,+),1 . *+/),+*/- . 6,328,839 5 1-+1*-+*1& . S8,486,S7S 5 3,268,666 5 3,+&1*+,)% .
:8 ";"<= $%&&'( 2,200,166 5 333+,/* . %+1*/+-1) . /+3/3+3-* . 6,102,397 5 1%+11%+1)) . S0,402,S48 5 2,816,870 5 -0+%%%+**0 .
>?@ A?B<5 C5 D $%&&'( S,048,S27 5 -0-+%0* . %+),0+)&0 . 2 . 1,298,208 5 /*+1&*+,%- . 72,883,410 5 4,073,268 5 ,0+/,%+%&* .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 43 - kepresentat|ve I.M. Lozano
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 10,246 77,6S0,039 5 2,986,S40 5 80,636,S79 5 4,307 11,74S,24S 5 6,021,9S6 5 17,767,202 5 98,403,781 5
8ee (100) 2,292 17,368,691 $ 668,027 $ 18,036,718 5 696 1,896,908 $ 972,372 $ 2,869,480 5 20,906,198 5
!l m Wel l s (100) 2,339 19,393,942 $ 743,998 $ 20,141,940 5 1,224 3,338,338 $ 1,711,727 $ S,0S0,28S 5 2S,192,22S 5
kl eberg (100) 2,203 16,713,031 $ 642,886 $ 17,3S7,917 5 836 2,334,120 $ 1,196,737 $ 3,S30,8S7 5 20,888,773 5
San aLrl cl o (100) 3,189 24,170,374 $ 929,630 $ 2S,100,004 5 1,331 4,173,639 $ 2,140,920 $ 6,316,S79 5 31,416,S83 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ @(80 A:+"#+3
9(:0&B
CDE<=CDEF G+H
2(%$3 I$/
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CDEE 9(:0&B
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7+$3&8%$6+ M
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CDE<=CDEF K,:3&1
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CDE<=CDEF K,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
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CDE<=CDEF
K,:3&1 4&$&+
Q:0,1 *(,+6$&+
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CDE<=CDEF K,:3&1
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4&$&+H-,+ I(&$3 CREDERSTCRSUC V CUWRTCFRDSD V CRU<<RDSFRXWW V ERWSXRXFSRWXC V <RSWDRFEERUUD V E<RCF<RDCSRDSE V CCRTXCRUUCRSWX V ERCWSRSEWRXEE V SERDSDR<FTRUE< V
;-1&6-%& I(&$3 ESRESFREEW V ERT<ERFC< V WRDSFRX<< V XR<<ERDSC V E<R<FWRXFX V EDERUFERSDC V EXSRSTFRCXX V TRESERWUF V CCDRWDFRE<D V
!"#$#% "&' )*++,- EDRDWTRWUT V *./*0.012 3 4.510.445 3 6.44*.+05 3 EDRFE<R<F< V 67.+62.247 3 EEEREDUR<EW V XRCDTRSTT V *2+.*45.410 3
89 % :;< )*++,- SRD<FRCUT V *5/.047 3 0.164.5+5 3 = 3 SRFX<RCDC V 05.2+2.120 3 UCRCTERW<T V CRTCCR<UW V 1+.664.66/ 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ @(80 A:+"#+3
9(:0&B
CDEF G,:3&1
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.06(33++1
*(,+6$&+
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L+,+6$3 L:0,1
*(,+6$&+
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CDEF G,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
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*(,+6$&+
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.06(33++1
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CDEF 98-3,6+0
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4&$&+ L:0,1
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G33 L:0,1
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98-3,6+0
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;-1&6-%& P(&$3 RQESD S<QEJRQS<F T CQDJ<QEIF T SFQCREQFJC T IQ<<< UQIUIQ<JU T <QJEFQERR T E<QCDUQFFF T RDQ<JEQI<J T
Cuadal upe (100) 4,862 36,843,963 $ 1,417,132 $ IJQCFIQEER T 2,324 6,883,008 $ 3,329,017 $ EDQ<ECQDCF T <JQFRSQE<I T
Wl l son (100) 2,288 17,341,381 $ 666,984 $ EJQDDJQSFS T 921 2,310,481 $ 1,287,160 $ IQRURQF<E T CEQJDFQCDF T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$1(0 !1$$%
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CDEE 9(:0&B
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!" #$%& ()**+, ERDCSR<CW U )-./0*1 2 .33/.40 2 5 2 =FFR=W< U 4/6*7/017 2 EDRT=<RSEE U WECRCDT U )0/6*1/)-. 2
8#9: ()**+, EDRFSTRDCD U -/113/*)3 2 0/1../41) 2 7/0.*/-0) 2 ESRVD=RVFC U 31/770/33* 2 EETRDS=RDSE U WRW=CR=W= U )4*/6.6/)43 2
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$1(0 !1$$%
9(:0&B
CDEF G,:3&1
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*(,+6$&+
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4&$&+ L:0,1
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4&$&+O-,+ P(&$3 EQDD<QRRE RQFE=QDJFQRII S CTCQJJRQT=E S RQTDRQTR<QFJ< S ==DQEJT EQ=DDQ<T=QIJ< S RFTQIC=Q=RF S CQCFTQJCDQTFD S EDQERRQRT=QF<< S
;-1&6-%& P(&$3 =QFJJ <IQEDJQ<=I S EQF=JQDER S <<QRFFQ<RE S CQFFC RQCFEQE=T S IQRCCQTDE S EDQTJ<QDFD S ==QR=DQ=IE S
8l anco (100) 479 3,632,786 $ 139,723 $ IQRRCQ=DJ S 171 463,922 $ 238,883 $ RD<QJDF S <Q<RRQIE= S
Pays (100) 3,209 39,473,668 $ 1,318,293 $ <DQTTIQTFI S 2,492 6,793,238 $ 3,484,016 $ EDQCRTQC=< S =EQCRIQCER S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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!"#$% & ()*+, FVSTEESXEE W -./0/.)*1 2 -3./)*.0-4 2 )4.546.011 2 <TSGUGSUE= W 45.04*.-)6 2 FTVSFEXSDF< W GSVVESXV< W )4-.314.*41 2
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;$A00$ ;:B+1
9(:0&C
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*(,+6$&+
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L+,+6$3 L:0,1
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4&$&+ L:0,1
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G33 L:0,1
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98-3,6+0
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4&$&+A-,+ O(&$3 FPEE<PQQF QP=FRPEJ=PQII S DTDPJJQPTRF S QPTEQPTQ<P=J< S RREPFJT FPREEP<TRPIJ< S Q=TPIDRPRQ= S DPD=TPJDEPT=E S FEPFQQPQTRP=<< S
;-1&6-%& O(&$3 RPTFD <<PJE=PEDJ S FPQDIPIET S <=PRDTPIIQ S DP=RI QPDI<P=ET S IPQETPDJJ S FEPT<IPJTQ S RQP<QIPDI< S
1ravl s (16) 3,912 44,806,028 $ 1,723,309 $ <=PRDTPIIQ S 2,633 7,234,609 $ 3,709,288 $ FEPT<IPJTQ S RQP<QIPDI< S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$:3 B(6C"$0
9(:0&D
EFG<>EFG= H+I
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;-1&6-%& J(&$3 GZTGGVT<VG X ETZE=TZEG X EZT==ZTYV= X GVTUZ<T<== X <ZTG<GTU=< X YYT<YFTFGF X G<ETUU=TUZY X =TVW<TY=U X GVETU<=TYGW X
!"#$% & ()*+, GZTGGVT<VG X -./-*./-) 0 -/.**/.12* 0 )2.3/4.4** 0 <ZTG<GTU=< X 11.415.5)5 0 G<ETUU=TUZY X =TVW<TY=U X )2-.34*.1)6 0
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!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4%+0$6-(
EFGH I,:3&1
4&$&+ N:0,1
*(,+6$&+
4%+0$6-(
EFGH I,:3&1
I33 N:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
JEFFM NA2
.06(33++1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
N+,+6$3 N:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
4&$&+ N:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
I33 N:0,1
*(,+6$&+
4%+0$6-(
EFGH I,:3&1 O
98-3,6+0
I33 N:0,1
*(,+6$&+
4%+0$6-(
4&$&+P-,+ Q(&$3 GRFF<R==G =RHGSRFLHR=KK T EUERLL=RUSG T =RUF=RU=<RHL< T SSFRGLU GRSFFR<USRKL< T =HURKESRS=H T EREHURLEFRUHF T GFRG==R=USRH<< T
;-1&6-%& Q(&$3 HREEL <=REFKR<K= T GRLGSRSG= T <URFGLRUS< T ER=US =RHEGR=F= T KRUF=R=SU T GGRSEUR<HH T HFRS<LR<EF T
1ravl s (17) 6,228 47,203,437 $ 1,813,317 $ <URFGLRUS< T 2,793 7,621,707 $ 3,907,739 $ GGRSEUR<HH T HFRS<LR<EF T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;(00$ 7(A$6,
9(:0&B
CDE<>CDEF G+A
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CDEE 9(:0&B
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7+$3&8%$6+ L
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9$6+ 9(1&1
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9(1&1 )(6 2(%$3
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7(1#-&$31
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4%+0$6-(
CDE<>CDEF J,:3&1
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J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
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4&$&+A-,+ H(&$3 CREDERSTCRSUC V CU=RTCFRDSD V CRU<<RDSFRW== V ER=SWRWFSR=WC V <RS=DRFEERUUD V E<RCF<RDCSRDSE V CCRTWCRUUCRS=W V ERC=SRSE=RWEE V SERDSDR<FTRUE< V
;-1&6-%& H(&$3 EURTDFR<WS V CRUTSRDUT V CWR<C<RW=W V ETREDTRFWW V <URUS<R<UE V =FRSEWRE=U V E<DR<WURECF V FR=UDRCS= V E=TR=EFRFWD V
!"#$% & ()*+, EURTDFR<WS V -./01.2/0 3 -4.5-5.464 3 )0.)20.*44 3 <URUS<R<UE V 6*.1)4.)6/ 3 E<DR<WURECF V FR=UDRCS= V )60.6)*.*42 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;(00$ 7(A$6,
9(:0&B
CDEF G,:3&1
HEI=J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
K+,+6$3 K:0,1
*(,+6$&+
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CDEF G,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
G33 K:0,1
*(,+6$&+
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HCDDJ KL2
.06(33++1
*(,+6$&+
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4&$&+ K:0,1
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*(,+6$&+
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98-3,6+0
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4&$&+A-,+ N(&$3 EODD<OPPE POFEQOD=FOPII R CSCO==POSQE R POSDPOSP<OF=< R QQDOE=S EOQDDO<SQOI=< R PFSOICQOQPF R COCFSO=CDOSFD R EDOEPPOPSQOF<< R
;-1&6-%& N(&$3 FOE<F <FOQ=COQ<Q R EOPSEOFIF R <=OIP<OE=E R COPQ= POQCEO<QQ R IO=QFOIQ= R EEOIPPO=EI R QSOPQEOSS< R
1ravl s (17) 6,146 46,382,343 $ 1,791,636 $ <=OIP<OE=E R 2,738 7,321,433 $ 3,836,338 $ EEOIPPO=EI R QSOPQEOSS< R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ .33-(&& A$-18&$&
9(:0&B
CDE<>CDEF A+G
2(%$3 H$/
?+@+0:+ IJ,:3&
./#$01-(0K
CDEE 9(:0&B
!0,-5+0&
7+$3&8%$6+ L
M06+-"N:61+,
O$-3 7+$3&8%$6+
9(1&1
CDEE H(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BP9(:0&B
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
CDED H(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
H(&$3
M06+-"N:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
CDE<>CDEF J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
CDE<>CDEF J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
CDE<>CDEF
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
CDE<>CDEF J,:3&1
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.08$0%+, 4%+0$6-(
4&$&+G-,+ H(&$3 CREDERS=CRSTC U CTVR=CFRDSD U CRT<<RDSFRWVV U ERVSWRWFSRVWC U <RSVDRFEERTTD U E<RCF<RDCSRDSE U CCR=WCRTTCRSVW U ERCVSRSEVRWEE U SERDSDR<F=RTE< U
;-1&6-%& H(&$3 ETRSVSR<WD U CRTDFRW<C U CTRTT<RCS= U EVR<VDRCFF U <<RDS<RTEW U V<R<S=R=SE U ESTRVSVREEE U FRT=ERW<W U EVSRTWTRDST U
!"#$% & ()*+, ETRSVSR<WD U -./01.*2- 3 -/.//2.-45 3 )6.260.-11 3 <<RDS<RTEW U 62.245.54) 3 ESTRVSVREEE U FRT=ERW<W U )64./*/.04/ 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ .33-(&& A$-18&$&
9(:0&B
CDEF G,:3&1
HEIJK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
G33 L:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
HCDDK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
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L+,+6$3 L:0,1
*(,+6$&+
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4&$&+ L:0,1
*(,+6$&+
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G33 L:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1 N
98-3,6+0
G33 L:0,1
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4&$&+O-,+ P(&$3 EQDD<QRRE RQFESQDJFQRII T C=CQJJRQ=SE T RQ=DRQ=R<QFJ< T SSDQEJ= EQSDDQ<=SQIJ< T RF=QICSQSRF T CQCF=QJCDQ=FD T EDQERRQR=SQF<< T
;-1&6-%& P(&$3 SQ=<< <SQD<JQDJS T EQRICQFE= T <FQRJDQRDI T CQFFR RQCRIQF=I T IQRC=QICR T EEQDDIQDCD T SRQRJIQRCI T
1ravl s (16) 3,944 43,048,083 $ 1,732,619 $ <FQRJDQRDI T 2,667 7,273,693 $ 3,729,327 $ EEQDDIQDCD T SRQRJIQRCI T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *$6A 4&6$"$
9(:0&B
C=DE>C=DF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
C=DD 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
C=DD I(&$3
7(1#-&$3 ;-1&6-%&
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7+$3&8%$6+
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C=D= I(&$3
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9$6+ 9(1&1
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98$6-&B 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
C=DE>C=DF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
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R:0,1 *(,+6$&+
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4&$&+H-,+ I(&$3 CSD=DSTUCST<C V C<WSUCFS=T= V CS<EES=TFSXWW V DSWTXSXFTSWXC V ESTW=SFDDS<<= V DESCFES=CTS=TD V CCSUXCS<<CSTWX V DSCWTSTDWSXDD V TDS=T=SEFUS<DE V
;-1&6-%& I(&$3 D<STD=S<EX V CSEU<SF<X V C<SETTSDDW V DWSTUCSXWX V ETSWC<SW=E V WES=TUSF=W V DT<SDUESCF< V FS<<<SXXE V DWCSXUESUWX V
!"#$% & ()*+, D<STD=S<EX V -./01.21* 3 -1./44.))5 3 )5.40-.*5* 3 ETSWC<SW=E V 5/.640.265 3 DT<SDUESCF< V FS<<<SXXE V )5-.*0/.05* 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *$6A 4&6$"$
9(:0&B
C=DE F,:3&1
GDHIJ KL2
.06(33++1
*(,+6$&+
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K+,+6$3 K:0,1
*(,+6$&+
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C=DE F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
C=DE F,:3&1
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*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
GC==J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
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C=DE 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
C=DE F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 DP==QPRRD RPED<P=IEPRHH S CTCPIIRPT<D S RPT=RPTRQPEIQ S <<=PDIT DP<==PQT<PHIQ S RETPHC<P<RE S CPCETPIC=PTE= S D=PDRRPRT<PEQQ S
;-1&6-%& O(&$3 <PTDE QQPIHQP<ET S DPRCQPQ=E S QEP<<IPTR< S CPE<Q RPCHTPCDR S HPRDDPE<D S D=PT<=PIEI S <RP<=TPIQQ S
1ravl s (16) 3,916 44,834,369 $ 1,724,406 $ QEP<<IPTR< S 2,634 7,239,217 $ 3,711,631 $ D=PT<=PIEI S <RP<=TPIQQ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ .,,-+ ?(,6-5:+A
9(:0&B
CD=E>CD=F G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
CD== 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
CD== I(&$3
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(6 9-&BQ9(:0&B
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7+$3&8%$6+
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!"#$% & ()*+, =XS=<<SW=D V -./00.12- 3 -/.40*.--4 3 )5.264.)6* 3 EXSCE<STT< V 44./*5.0/2 3 =ECSX<WSDXW V FSUFCSFUX V )5-.*4).)52 3
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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1ravl s (17) 6,242 47,309,791 $ 1,819,607 $ QTP=CTPHTT S 2,801 7,638,880 $ 3,916,363 $ ==P<<<PQQH S EDPEIQPIQC S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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Wl l l l amson (39) 3,264 39,893,338 $ 1,334,339 $ REQR=SQFUJ T 2,393 7,072,449 $ 3,626,146 $ EDQFUJQ<UF T <=QE=FQ=UI T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+N-,+ O(&$3 EPDDQPRRE RPFE<PDIFPR== S CTCPIIRPT<E S RPTDRPTRQPFIQ S <<DPEIT EP<DDPQT<P=IQ S RFTP=C<P<RF S CPCFTPICDPTFD S EDPERRPRT<PFQQ S
;-1&6-%& O(&$3 RPFF= <IPDRTP=IF S CPC==PIC= S FDP=E=PCDI S CPTTR IPER=P=EF S QPETDP<RR S ECP=F=PIT= S RCPFRRPEDE S
8andera (100) 928 7,036,639 $ 270,640 $ RP=DRPCRT S 297 810,441 $ 413,323 $ EPCC<PTFF S IP<==PCQ< S
CrockeLL (100) 199 1,309,142 $ 38,044 $ EP<FRPEIF S 98 268,233 $ 137,327 $ QD<PRFD S EPTRCPTQF S
Ldwards (100) 110 831,384 $ 31,976 $ IF=P=FD S 40 109,308 $ 36,146 $ EF<PF<Q S EPDCTPDEQ S
kerr (100) 2,186 16,367,430 $ 637,209 $ ERPCDQPF=T S 831 2,267,267 $ 1,162,460 $ =PQCTPRCR S CDPF=QP=FF S
kl mbl e (100) 202 1,333,240 $ 38,971 $ EP<TCPCEE S 73 203,891 $ 103,364 $ =EEPQ<< S EPTD=PFFF S
Ll ano (100) 742 3,623,889 $ 216,303 $ <PIQDPET= S 214 384,863 $ 299,868 $ IIQPR=E S FPRCQPTC= S
Mason (100) 167 1,268,161 $ 48,773 $ EP=EFPT=R S 63 176,771 $ 90,633 $ CFRPQD< S EP<IQP=QE S
Medl na (100) 2,304 18,980,230 $ 730,010 $ ETPREDPCFD S 1,086 2,962,868 $ 1,319,103 $ QPQIEPTR= S CQPETCPC== S
Menard (100) 99 733,063 $ 28,964 $ RICPDCT S 38 102,946 $ 32,782 $ E<<PRCR S T=RPR<R S
8eal (100) 143 1,087,426 $ 41,824 $ EPECTPC<D S 31 140,269 $ 71,918 $ CECPEIF S EP=QEPQ=F S
Schl el cher (100) 163 1,247,076 $ 47,964 $ EPCT<PDQD S 92 249,777 $ 128,064 $ =RRPIQE S EPFRCPIIE S
SuLLon (100) 217 1,641,682 $ 63,142 $ EPRDQPIC= S 108 294,482 $ 130,983 $ QQ<PQFR S CPE<DPCTE S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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EFG=>EFGH
B,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
EFG=>EFGH B,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+J-,+ K(&$3 ESGFGSTUEST<E V E<WSUEHSFTF V ES<==SFTHSXWW V GSWTXSXHTSWXE V =STWFSHGGS<<F V G=SEH=SFETSFTG V EESUXES<<ESTWX V GSEWTSTGWSXGG V TGSFTFS=HUS<G= V
;-1&6-%& K(&$3 G=SEEGSXEG V =SGEHSEXT V HSGE<SGX< V TTSU<<SWWE V =GSFWGSF=X V WWSH=ESWTG V G=ESHXFSGXX V HSUHWS<FE V GUESUGUSGX= V
!"# # %&'() GESEXESGGX V &*+,-*+&. / 0*,12*2-0 / 22*-00*''1 / TUSXHUSEHH V ,0*&&0*,-2 / GEGSTXUSEW< V XSHWTSFEF V .3&*+.1*030 /
45675858 %.++() GSU<US<F< V &'*111 / .*&+.*,,+ / 9 / GS=FGSHHF V .2*1-,*+2' / EGSTUFSWWG V GSGU<S=WE V 1'*-+3*0-- /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-""-+ BC%(%D
9(:0&C
EFGH B,:3&1
IGJKL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1
B33 M:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
IEFFL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
B33 M:0,1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1 O
98-3,6+0
B33 M:0,1
*(,+6$&+
4%+0$6-(
4&$&+P-,+ Q(&$3 GRFF=RSSG SRHG<RFKHRSJJ T EUERKKSRU<G T SRUFSRUS=RHK= T <<FRGKU GR<FFR=U<RJK= T SHURJE<R<SH T EREHURKEFRUHF T GFRGSSRSU<RH== T
;-1&6-%& Q(&$3 HRE=S =SRJ=JRH<F T GRKEFRUGF T =URGH=R<HF T JRSFH GFRGF<RUS= T <RGKGR=SK T G<REKSR=<E T H=R=<ERFGG T
8el l (48) 3,311 40,249,778 $ 1,348,068 $ =GRSUSRK=H T 3,337 9,100,713 $ 4,666,067 $ GJRSHHRSKE T <<R<H=RHEK T
Lampasas (100) 936 7,093,872 $ 272,841 $ SRJHHRSG= T 369 1,003,239 $ 313,411 $ GR<EFRHHU T KRKKSRJKJ T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ >$3#8 48+))-+3,
9(:0&@
ABCD=ABCE F+G
2(%$3 H$/
>+?+0:+ IJ,:3&
./#$01-(0K
ABCC 9(:0&@
!0,-5+0&
7+$3&8%$6+ L
M06+-"N:61+,
O$-3 7+$3&8%$6+
9(1&1
ABCC H(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&@P9(:0&@
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
ABCB H(&$3
7(1#-&$3 98$6-&@
9$6+ 9(1&1
H(&$3
M06+-"N:61+,
98$6-&@ 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
ABCD=ABCE J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
ABCD=ABCE J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
ABCD=ABCE
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
ABCD=ABCE J,:3&1
Q+,+6$3 Q:0,1
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4&$&+G-,+ H(&$3 ARCBCRSTARS<A U A<VRTAERBSB U AR<DDRBSERWVV U CRVSWRWESRVWA U DRSVBRECCR<<B U CDRAEDRBASRBSC U AARTWAR<<ARSVW U CRAVSRSCVRWCC U SCRBSBRDETR<CD U
;-1&6-%& H(&$3 CSRDSCRAES U DRDWERTW< U WRAWTRCBD U SERCTSRDEE U DSRDWAR<VA U VARWSTRSSA U CSARTDCRDTE U ERDATREWA U CETRW<BRWTC U
!"# # %&'() CSRDSCRAES U *+*,-+.,& / ,+',.+01* / 2-+0.2+*-- / DSRDWAR<VA U 3'+,2.+22' / CSARTDCRDTE U ERDATREWA U 0-.+,&1+,.0 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ >$3#8 48+))-+3,
9(:0&@
ABCD E,:3&1
FCGHI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1
E33 J:0,1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
FABBI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
ABCD 98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
ABCD E,:3&1 L
98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 COBBPOQQC QODC<OBHDOQGG R ASAOHHQOS<C R QOSBQOSQPODHP R <<BOCHS CO<BBOPS<OGHP R QDSOGA<O<QD R AOADSOHABOSDB R CBOCQQOQS<ODPP R
;-1&6-%& N(&$3 <OHCQ PPOBHQOPQH R CODS<ODQA R P<OQHGOC<C R GOD<< SOSDHOPPA R <OCCBOSDP R C<OBQSOPB< R DBOHDAO<<D R
8el l (32) 3,817 44,087,478 $ 1,693,672 $ P<OQHGOC<C R 3,633 9,968,442 $ 3,110,964 $ C<OBQSOPB< R DBOHDAO<<D R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 98$63+1 A;(%A B0,+61(0
9(:0&C
DEFG>DEFH I+J
2(%$3 K$/
?+@+0:+ LB,:3&
./#$01-(0M
DEFF 9(:0&C
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
DEFF K(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CR9(:0&C
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
DEFE K(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
K(&$3
O06+-"P:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
DEFG>DEFH B,:3&1
S+,+6$3 S:0,1
2-"-&+,
4%+0$6-(
DEFG>DEFH B,:3&1
S+,+6$3 S:0,1
*(,+6$&+
4%+0$6-(
DEFG>DEFH
B,:3&1 4&$&+
S:0,1 *(,+6$&+
4%+0$6-(
DEFG>DEFH B,:3&1
S+,+6$3 S:0,1
.08$0%+, 4%+0$6-(
4&$&+J-,+ K(&$3 DTFEFTUVDTU<D W D<XTVDHTEUE W DT<GGTEUHT=XX W FTXU=T=HUTX=D W GTUXETHFFT<<E W FGTDHGTEDUTEUF W DDTV=DT<<DTUX= W FTDXUTUFXT=FF W UFTEUETGHVT<FG W
;-1&6-%& K(&$3 FFTXGGTDVD W UTHHFTVE= W <TUEETVGG W DUTXD=TE=< W DVTFDHTEFE W FUUTUDFTU<E W DFGTGHUTGFH W FFTVX=TUHU W DXVTXDXTVHU W
!"#$%%&% ()*+, FFTXGGTDVD W -.))/.0*1 2 3.-**.044 2 5-.651.*13 2 DVTFDHTEFE W /--.-5/.-3* 2 DFGTGHUTGFH W FFTVX=TUHU W 560.656.0)- 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 98$63+1 A;(%A B0,+61(0
9(:0&C
DEF= B,:3&1
GFHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
DEF= B,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DEF= B,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DEF= B,:3&1
B33 K:0,1
*(,+6$&+
4%+0$6-(
DEF= 98-3,6+0
GDEEJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
DEF= 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DEF= 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DEF= 98-3,6+0
B33 K:0,1
*(,+6$&+
4%+0$6-(
DEF= B,:3&1 M
98-3,6+0
B33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 FPEEQPRRF RP=F<PEI=PRHH S DTDPIIRPT<F S RPTERPTRQP=IQ S <<EPFIT FP<EEPQT<PHIQ S R=TPHD<P<R= S DPD=TPIDEPT=E S FEPFRRPRT<P=QQ S
;-1&6-%& O(&$3 TPHI< RFPFD<PT=Q S DPRH<P=FQ S RHPI=FP<RI S HPTEI FEP=<RPREF S <PQ=QPH<R S F=PFDDPE<I S ITPTIHP=H= S
McLennan (70) 9,383 71,123,964 $ 2,733,614 $ RHPI=FP<RI S 3,908 10,637,701 $ 3,464,337 $ F=PFDDPE<I S ITPTIHP=H= S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A6+0& B18CD
9(:0&D
EFGH>EFG= I+J
2(%$3 A$/
?+@+0:+ KB,:3&
./#$01-(0L
EFGG 9(:0&D
!0,-5+0&
7+$3&8%$6+ M
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O$-3 7+$3&8%$6+
9(1&1
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7+$3&8%$6+
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7(1#-&$3 98$6-&D
9$6+ 9(1&1
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98$6-&D 9$6+
9(1&1 )(6 2(%$3
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Q+,+6$3 Q:0,1
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4&$&+J-,+ A(&$3 ERGFGRSTERS<E U E<VRTE=RFSF U ER<HHRFS=RWVV U GRVSWRW=SRVWE U HRSVFR=GGR<<F U GHRE=HRFESRFSG U EERTWER<<ERSVW U GREVSRSGVRWGG U SGRFSFRH=TR<GH U
;-1&6-%& A(&$3 GFRVV<REW= U GRWHTRFSV U WREHER=G< U ER=VHRSSW U TRFE=RF<G U GE<RWF=RWFH U EFERFWHRS<F U GGRETERVWE U E=SRF<TRTWG U
!"#$% & "' )*++,- WRF==RVHH U *.*+/.*/0 1 2.23+./40 1 5 1 ERE<FRHVT U 63.03/./74 1 GFWRGFFR<VV U <RTETRWTE U */7.780.*44 1
9:;<=:" )*++,- GRHWFRTVS U **/.*38 1 *./2*.*44 1 2.84/.776 1 HREF<R<EH U 2+.+3+.+*/ 1 SERE<HRSWG U GRVFERWGH U /7.346.084 1
>$:" )*++,- GREGGRVH= U /0.//6 1 36.467 1 5 1 <WRVWS U **.+82.706 1 G=RVGERGGF U TT<RH=S U 2/.+8+./2* 1
?'@& <:" )*++,- =GTRVFH U 28+./8* 1 /3+.338 1 5 1 H<FR<<= U **.0+4.+/4 1 GTRG<WRHEF U GRF=FRWFH U 23.448.+36 1
A'" !;#;<=& "$ )*++,- <H=RSVW U 5 1 *.+3+.42+ 1 5 1 GRF<FRVEF U 6.87+.70+ 1 GFRVE=RGH= U WF<RGFE U */.67*.24* 1
BC& "& =D )*++,- VW=RHFG U **+.4*3 1 *.+*2.804 1 5 1 GRFGER=TV U 0.402.7*0 1 G<RTGSR=EW U VVTRS=V U 2*.3+3.+78 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A6+0& B18CD
9(:0&D
EFGH B,:3&1
IGJKL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EFGH B,:3&1
B33 M:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
IEFFL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EFGH 98-3,6+0
4&$&+ M:0,1
*(,+6$&+
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EFGH 98-3,6+0
B33 M:0,1
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98-3,6+0
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*(,+6$&+
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4&$&+P-,+ A(&$3 GQFFRQ==G =QHG<QFKHQ=JJ S ETEQKK=QT<G S =QTF=QT=RQHKR S <<FQGKT GQ<FFQRT<QJKR S =HTQJE<Q<=H S EQEHTQKEFQTHF S GFQG==Q=T<QHRR S
;-1&6-%& A(&$3 KQKRE H=QFGFQ=J= S EQ<==QJJH S HTQ<KKQF=J S JQREJ TQJJRQFGT S RQ=K<QHKH S GRQGGTQ=FR S KJQ=F=Q=== S
Angel l na (100) 4,643 33,186,209 $ 1,333,316 $ JHQ<JTQ<E< S 2,039 3,361,940 $ 2,831,687 $ KQRGJQHEH S RRQT<JQG<E S
PousLon (100) 1,411 10,696,333 $ 411,403 $ GGQGF=QTRG S 429 1,169,316 $ 399,323 $ GQ=HKQKRG S GEQK=HQ=KG S
Leon (100) 779 3,907,042 $ 227,194 $ HQGJRQEJH S 299 813,363 $ 418,048 $ GQEJJQRGG S =QJH=QHR= S
Madl son (100) 838 6,332,836 $ 244,341 $ HQ<T=QGT= S 262 713,698 $ 366,949 $ GQFKEQHR= S =QH=TQKRR S
San AugusLl ne (100) 474 3,390,614 $ 138,101 $ JQ=EKQ=GR S 136 423,728 $ 218,277 $ HRRQFFR S RQJ=EQ=GT S
1rl nl Ly (100) 696 3,277,480 $ 202,980 $ <QRKFQRHF S 237 643,974 $ 331,200 $ T==QG=R S HQR<=QHJR S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!"#$%& ()**+, FTDGFTHDX W )-*./*) 0 12-.343 0 5 0 <D=TGUG W )*./6*.672 0 FHTXG=TXFD W V=XTUUX W 24.-3/.36/ 0
8"9:#": ()**+, FETXE<TGV< W ).1*3.7*- 0 )./*7.262 0 5 0 FTVEXTDHD W 32.*3-.**) 0 XHTXGDTGFH W UTH=ETUXU W /).3*-.7-2 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?(A B66
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4&$&+ L:0,1
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98-3,6+0
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4&$&+O-,+ P(&$3 FQEERQSSF SQGF<QE=GQSJJ T DUDQ==SQU<F T SQUESQUSRQG=R T <<EQF=U FQ<EEQRU<QJ=R T SGUQJD<Q<SG T DQDGUQ=DEQUGE T FEQFSSQSU<QGRR T
;-1&6-%& P(&$3 JQSJD D=QD=<QFDD T FQE=SQ==U T DUQJSJQEFF T DQESE <QGR<QFUU T DQ=URQJS< T =Q<JUQ<SJ T JSQUFDQ<=R T
8osque (100) 772 3,832,821 $ 223,109 $ GQESSQUJE T 312 830,633 $ 436,133 $ FQD=GQSG= T SQJGRQGU= T
!ohnson (100) 2,960 22,432,300 $ 862,781 $ DJQDU<QE=F T 1,738 4,794,364 $ 2,438,242 $ SQD<DQ=E< T JEQ<RSQ==S T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct S9 - kepresentat|ve I.D. Sheff|e|d
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 11,871,0S3 5 2,081,06S 5 6,464,233 5 4,S66,833 5 11,031,066 5 9S,874,18S 5 1S4,232,341 5 8,619,6S3 5 208,422,10S 5
!"#$%&'( *+,,-. 1,030,906 5 /,/01,2 3 /0++40561 3 +1,062, 3 2,304,299 5 70215087/ 3 13,670,181 5 763,992 5 +702540//, 3
!"9:(; ; *+,,-. S,760,771 5 5660258 3 +0,880/,7 3 4710,7, 3 1,4SS,288 5 47045501,6 3 61,738,3S2 5 3,4S0,399 5 74024,0/+6 3
<9$=' *+,,-. 2,4S7,400 5 4510+51 3 76608,7 3 40//60177 3 4,081,S96 5 /8062701,8 3 42,709,097 5 2,386,903 5 6505+60,,/ 3
>$#? ; ="% *+,,-. 620,17S 5 2601+2 3 8480/65 3 4660581 3 992,026 5 205,10,+6 3 7,S7S,369 5 423,368 5 +,0/480175 3
@&!A; ; "&' *+,,-. 604,0S6 5 B 3 66,0751 3 +510617 3 730,477 5 60/850117 3 8,474,604 5 473,624 5 ++026/0+81 3
@? ; ; C *+,,-. 367,410 5 61061/ 3 /870854 3 B 3 268,673 5 /05/50+84 3 4,387,174 5 24S,188 5 601/708+6 3
D$% D$E$ *+,,-. 380,938 5 +11022, 3 225046+ 3 B 3 447,3S1 5 2041/07// 3 7,066,712 5 394,941 5 1062108++ 3
D"#(9F(; ; *+,,-. 649,398 5 247068, 3 6/60215 3 //60767 3 7S1,3SS 5 6046/0814 3 8,610,8S2 5 481,239 5 ++08480/75 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct S9 - kepresentat|ve I.D. Sheff|e|d
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 6,749 S1,148,17S 5 1,967,238 5 S3,11S,413 5 3,183 8,679,842 5 4,4S0,280 5 13,130,121 5 66,24S,S34 5
Comanche (100) 398 4,333,431 $ 174,364 $ 4,707,81S 5 273 749,330 $ 384,192 $ 1,133,S22 5 S,841,337 5
Coryel l (100) 2,701 20,474,331 $ 787,474 $ 21,261,806 5 1,379 4,307,313 $ 2,208,422 $ 6,S1S,737 5 27,777,S42 5
LraLh (100) 1,869 14,163,647 $ 344,736 $ 14,708,402 5 672 1,832,926 $ 939,768 $ 2,772,694 5 17,481,096 5
Paml l Lon (100) 331 2,312,223 $ 96,624 $ 2,608,849 5 128 349,831 $ 179,374 $ S29,22S 5 3,138,074 5
McCul l och (100) 371 2,810,439 $ 108,094 $ 2,918,S32 5 163 449,106 $ 230,263 $ 679,369 5 3,S97,901 5
Ml l l s (100) 192 1,434,922 $ 33,939 $ 1,S10,880 5 88 238,703 $ 122,386 $ 361,089 5 1,871,969 5
San Saba (100) 309 2,343,338 $ 90,136 $ 2,433,674 5 103 283,869 $ 146,369 $ 432,438 5 2,866,113 5
Somervel l (100) 377 2,833,623 $ 109,832 $ 2,96S,4S4 5 171 466,742 $ 239,303 $ 706,047 5 3,671,S01 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 60 - kepresentat|ve Iames L. keffer
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 13,339,900 5 2,440,SS3 5 13,672,309 5 2,123,778 5 1S,796,087 5 106,80S,423 5 171,817,371 5 9,602,436 5 232,18S,662 5
!"#$% '())*+ 2,SS7,46S 5 ,-,./01 2 (.3-0.,44 2 534.(-( 2 2,096,098 5 -/.(0-./)( 2 40,S10,968 5 2,264,0SS 5 /5.455.//0 2
678 8 797% '())*+ 93S,102 5 (0).555 2 -)4./(( 2 : 2 207,S11 5 0.)0/./)1 2 13,007,109 5 726,934 5 (4./44.(43 2
6#8 ;<7% '())*+ 603,396 5 ().3/4 2 (.-0-.504 2 : 2 1,282,487 5 /.1,4.031 2 8,683,S17 5 48S,300 5 ((.415.505 2
=7>?8 7%@ '())*+ 1,829,181 5 -(/./4/ 2 ,/-./-, 2 : 2 9S2,S29 5 ((.5/).3,0 2 18,420,682 5 1,029,48S 5 -5.0,-.0(4 2
A##@ '())*+ 4,36S,SS2 5 -54.401 2 0/).15- 2 (.)1-.1)5 2 1,882,646 5 1)./5).05) 2 49,130,903 5 2,74S,801 5 33.1,1.((, 2
B78 # BC %?# '())*+ 1,977,723 5 (15.411 2 /.),,.)1/ 2 3-5.1/1 2 S,723,388 5 (4.,4-.(4/ 2 28,911,7S2 5 1,61S,804 5 1,.)3,.,1, 2
D97EF;8 G#"@ '())*+ 311,S16 5 : 2 ,,)./3/ 2 : 2 990,S6S 5 (.,43.-)/ 2 3,179,112 5 177,672 5 5.-,3.),0 2
D?;H9;%> '())*+ 7S9,96S 5 4-(.440 2 -.33).035 2 : 2 2,660,864 5 3.(,,.310 2 9,973,328 5 SS7,384 5 (1.544.54- 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 60 - kepresentat|ve Iames L. keffer
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 7,S18 S6,979,911 5 2,191,S3S 5 S9,171,446 5 2,911 7,939,S3S 5 4,070,714 5 12,010,249 5 71,181,694 5
8rown (100) 1,773 13,434,680 $ 316,718 $ 13,9S1,398 5 712 1,940,793 $ 993,073 $ 2,93S,866 5 16,887,264 5
Cal l ahan (100) 369 4,313,336 $ 163,906 $ 4,479,462 5 214 384,433 $ 299,637 $ 884,110 5 S,363,S73 5
Col eman (100) 380 2,879,721 $ 110,738 $ 2,990,479 5 147 400,709 $ 203,449 $ 606,1S8 5 3,S96,637 5
LasLl and (100) 806 6,108,863 $ 234,936 $ 6,343,820 5 310 843,713 $ 433,609 $ 1,279,323 5 7,623,143 5
Pood (100) 2,130 16,293,314 $ 626,666 $ 16,919,980 5 760 2,073,680 $ 1,063,203 $ 3,136,88S 5 20,0S6,86S 5
al o l nLo (100) 1,263 9,388,024 $ 368,770 $ 9,9S6,794 5 332 1,430,673 $ 743,781 $ 2,194,4S4 5 12,1S1,248 5
Shackel ford (100) 139 1,034,291 $ 40,330 $ 1,094,841 5 38 138,313 $ 81,170 $ 239,48S 5 1,334,326 5
SLephens (100) 436 3,307,462 $ 127,210 $ 3,434,672 5 178 483,198 $ 248,768 $ 733,967 5 4,168,638 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A8-3 B-05
9(:0&C
DE=F>DE=G H+I
2(%$3 J$/
?+@+0:+ KL,:3&
./#$01-(0M
DE== 9(:0&C
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
DE== J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CR9(:0&C
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
DE=E J(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
DE=F>DE=G L,:3&1
S+,+6$3 S:0,1
2-"-&+,
4%+0$6-(
DE=F>DE=G L,:3&1
S+,+6$3 S:0,1
*(,+6$&+
4%+0$6-(
DE=F>DE=G
L,:3&1 4&$&+
S:0,1 *(,+6$&+
4%+0$6-(
DE=F>DE=G L,:3&1
S+,+6$3 S:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 DT=E=TUVDTUWD X DWYTVDGTEUE X DTWFFTEUGT<YY X =TYU<T<GUTY<D X FTUYETG==TWWE X =FTDGFTEDUTEU= X DDTV<DTWWDTUY< X =TDYUTU=YT<== X U=TEUETFGVTW=F X
;-1&6-%& J(&$3 =UTV<FTFEW X YEFTD<E X =GTYE<T=== X FTWFETVYE X DDTUFGTEV= X G=T<WGTDE= X ==WTDGFTWV< X <TFFDTFEF X =WWTGG<TFVY X
!"#$%# '())*+ VTWFETEFW X (,-./0/ 1 (2./-,.)-) 1 3 1 =FTVW<TEWE X 40.20(.)-5 1 WDT=WWT<E= X DTV=FTYFF X 6).25).-2/ 1
78 9% '())*+ FTFDFTU<E X ,45.44( 1 0.5-).),( 1 2.-2)./5) 1 GTUV=TEF= X 4/.04,.(24 1 <UT==YTVVW X UTWDGTW<E X 5-.0/-./2/ 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A8-3 B-05
9(:0&C
DE=< F,:3&1
G=HIJ KA2
.06(33++1
*(,+6$&+
4%+0$6-(
DE=< F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DE=< F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DE=< F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
DE=< 98-3,6+0
GDEEJ KA2
.06(33++1
*(,+6$&+
4%+0$6-(
DE=< 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DE=< 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DE=< 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
DE=< F,:3&1 L
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 =OEEPOQQ= QO<=ROEI<OQHH S DTDOIIQOTR= S QOTEQOTQPO<IP S RREO=IT =OREEOPTROHIP S Q<TOHDRORQ< S DOD<TOIDEOT<E S =EO=QQOQTRO<PP S
;-1&6-%& N(&$3 ROEPP HIODDIORTD S =OPQEOHHE S HTO<TIOTDD S DODDQ <OEQHOHIQ S HO==HOT=H S TO=IQOHEE S PIOII<ODDH S
arker (100) 2,282 17,296,397 $ 663,246 $ =QOT<=O<PH S 1,093 2,986,246 $ 1,331,091 $ POR=QOHHI S DDOPQIOTI= S
Wl se (100) 2,762 20,932,193 $ 803,084 $ D=OQHQODQT S 1,132 3,087,141 $ 1,382,822 $ PO<<TOT<H S D<OPEQODPD S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 2$66A B8-33-#1
9(:0&A
=CDE>=CDF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
=CDD 9(:0&A
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
=CDD I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&AQ9(:0&A
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
=CDC I(&$3
7(1#-&$3 98$6-&A
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&A 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
=CDE>=CDF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
=CDE>=CDF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
=CDE>=CDF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
=CDE>=CDF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 =SDCDSTU=STV= W =VXSU=FSCTC W =SVEESCTFS<XX W DSXT<S<FTSX<= W ESTXCSFDDSVVC W DES=FESC=TSCTD W ==SU<=SVV=STX< W DS=XTSTDXS<DD W TDSCTCSEFUSVDE W
;-1&6-%& I(&$3 DCSFUXSVXC W TSECCSDEF W VSUCFSCDD W DSUUFSTCD W FSUCESTD= W UTSVUXSF=< W DVCSVFDSX=D W XSEDVSCF< W =CTSEFVSEVV W
!"# $% '())*+ T=CSCXV W ,-.(/- 0 ()1.,,2 0 3 0 DCVSUUX W 4.15-.2(5 0 VSFTDSEXV W T=CSTDX W /./61.-1) 0
7%889 8 '())*+ =SCU<SX<T W -,5.-)) 0 (.)(,./5/ 0 3 0 DSCDUSF<F W -6.1-/.14) 0 TUSEVFST=C W =S=CVSD<U W 14.4-)./)2 0
:;%<=>8 '())*+ XSTXDS<T= W 4.)((.//1 0 6./2(.-6/ 0 (.,,/.4)( 0 <SFFXSVEX W 51.1)2.42) 0 DCVSTXTSCDF W VSXXUSVXU W (6-.6),.6,/ 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 2$66A B8-33-#1
9(:0&A
=CD< E,:3&1
FDGHI JB2
.06(33++1
*(,+6$&+
4%+0$6-(
=CD< E,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
=CD< E,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
=CD< E,:3&1
E33 J:0,1
*(,+6$&+
4%+0$6-(
=CD< 98-3,6+0
F=CCI JB2
.06(33++1
*(,+6$&+
4%+0$6-(
=CD< 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
=CD< 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
=CD< 98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
=CD< E,:3&1 K
98-3,6+0
E33 J:0,1
*(,+6$&+ 4%+0$6-(
4&$&+L-,+ M(&$3 DNCCONPPD PN<DQNCH<NPGG R =S=NHHPNSQD R PNSCPNSPON<HO R QQCNDHS DNQCCNOSQNGHO R P<SNG=QNQP< R =N=<SNH=CNS<C R DCNDPPNPSQN<OO R
;-1&6-%& M(&$3 <NQHS OSNSGON=GO R DNS=CNQOP R QDNHQONPH= R =NHHH PNHP<NGPG R ONCGHNGGC R DDNSDONPCG R <GNP<SNOHQ R
uel La (100) 231 1,900,736 $ 73,103 $ DNSPGNHOD R 90 243,673 $ 123,961 $ GPDN<G< R =NGOQNOPH R
lannl n (100) 1,727 13,083,238 $ 303,279 $ DGNQHHNQGP R 367 1,346,647 $ 792,988 $ =NGGSN<GQ R DQNS=HNDPD R
Crayson (100) 4,611 34,948,241 $ 1,344,163 $ G<N=S=NOCO R 2,231 6,084,031 $ 3,119,381 $ SN=CGNOG= R OQNOSQNHGQ R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$0 B$6C+6
9(:0&D
EFGH>EFGI J+K
2(%$3 A$/
?+@+0:+ LM,:3&
./#$01-(0N
EFGG 9(:0&D
!0,-5+0&
7+$3&8%$6+ O
P06+-"Q:61+,
R$-3 7+$3&8%$6+
9(1&1
EFGG A(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DS9(:0&D
P06+-"Q:61+,
7+$3&8%$6+
./#+0,-&:6+1
EFGF A(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
A(&$3
P06+-"Q:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
R:6-1,-%&-(01 O
7(1#-&$31
EFGH>EFGI M,:3&1
T+,+6$3 T:0,1
2-"-&+,
4%+0$6-(
EFGH>EFGI M,:3&1
T+,+6$3 T:0,1
*(,+6$&+
4%+0$6-(
EFGH>EFGI
M,:3&1 4&$&+
T:0,1 *(,+6$&+
4%+0$6-(
EFGH>EFGI M,:3&1
T+,+6$3 T:0,1
.08$0%+, 4%+0$6-(
4&$&+K-,+ A(&$3 EUGFGU=VEU=WE X EWYUVEIUF=F X EUWHHUF=IU<YY X GUY=<U<I=UY<E X HU=YFUIGGUWWF X GHUEIHUFE=UF=G X EEUV<EUWWEU=Y< X GUEY=U=GYU<GG X =GUF=FUHIVUWGH X
;-1&6-%& A(&$3 GHUY<=UIVF X GUE=IUFIE X EUV<EU=WF X > X EUV<EU=WF X W=U=VEUGIH X YWUYVGUI=H X HUYFFUEIF X GG<UF<VUVEH X
!"#$%# '()*+ GHUY<=UIVF X ,-(./-0/( 1 (-23(-.)0 1 4 1 EUV<EU=WF X ).-.2(-,/5 1 YWUYVGUI=H X HUYFFUEIF X ,,3-032-2(5 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$0 B$6C+6
9(:0&D
EFG< H,:3&1
IG=JK LB2
.06(33++1
*(,+6$&+
4%+0$6-(
EFG< H,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
EFG< H,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
EFG< H,:3&1
H33 L:0,1
*(,+6$&+
4%+0$6-(
EFG< 98-3,6+0
IEFFK LB2
.06(33++1
*(,+6$&+
4%+0$6-(
EFG< 98-3,6+0
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
EFG< 98-3,6+0
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
EFG< 98-3,6+0
H33 L:0,1
*(,+6$&+
4%+0$6-(
EFG< H,:3&1 M
98-3,6+0
H33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ A(&$3 GOFFPOQQG QO<GROFJ<OQ== S ETEOJJQOTRG S QOTFQOTQPO<JP S RRFOGJT GORFFOPTRO=JP S Q<TO=ERORQ< S EOE<TOJEFOT<F S GFOGQQOQTRO<PP S
;-1&6-%& A(&$3 =OQRJ EJOPJPO==P S GOFTRORRG S ETORQTOJJR S EOFR= RORTJO=QG S EOJQFO=<R S JOP<JOQ=< S =JOFPJO<EG S
uenLon (23) 3,738 28,484,334 $ 1,093,331 $ ETORQTOJJR S 2,033 3,398,371 $ 2,870,363 $ JOP<JOQ=< S =JOFPJO<EG S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *A6$ 96(B0(@+6
9(:0&A
CDE=>CDEF G+B
2(%$3 H$/
?+@+0:+ IJ,:3&
./#$01-(0K
CDEE 9(:0&A
!0,-5+0&
7+$3&8%$6+ L
M06+-"N:61+,
O$-3 7+$3&8%$6+
9(1&1
CDEE H(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&AP9(:0&A
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
CDED H(&$3
7(1#-&$3 98$6-&A
9$6+ 9(1&1
H(&$3
M06+-"N:61+,
98$6-&A 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
CDE=>CDEF J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
CDE=>CDEF J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
CDE=>CDEF
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
CDE=>CDEF J,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+B-,+ H(&$3 CREDERSTCRSUC V CUWRTCFRDSD V CRU==RDSFR<WW V ERWS<R<FSRW<C V =RSWDRFEERUUD V E=RCF=RDCSRDSE V CCRT<CRUUCRSW< V ERCWSRSEWR<EE V SERDSDR=FTRUE= V
;-1&6-%& H(&$3 E=RWW<RDWU V ERCSWRTCW V CRT<<RFTS V > V CRT<<RFTS V USR=FCRC<E V W<RDCDRU<T V =RWDFR=FE V EE<RC==RDCU V
!"#$%# '()*+ E=RWW<RDWU V ,-(./-0(/ 1 (-022-30. 1 4 1 CRT<<RFTS V ).-53(-(2, 1 W<RDCDRU<T V =RWDFR=FE V ,,2-(55-6() 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *A6$ 96(B0(@+6
9(:0&A
CDE< F,:3&1
GEHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
GCDDJ KL2
.06(33++1
*(,+6$&+
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CDE< 98-3,6+0
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*(,+6$&+
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CDE< 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+B-,+ N(&$3 EODD=OPPE PO<EQODI<OPHH R CSCOIIPOSQE R POSDPOSP=O<I= R QQDOEIS EOQDDO=SQOHI= R P<SOHCQOQP< R COC<SOICDOS<D R EDOEPPOPSQO<== R
;-1&6-%& N(&$3 HOP<= CIOQCPODQS R EODSPOESQ R CSO<C=OCQ= R CODQ< QO<D<OP<I R COIP=O<PE R IO=IEO=HS R HIOEDQO<SH R
uenLon (23) 3,764 28,327,039 $ 1,097,193 $ CSO<C=OCQ= R 2,036 3,606,768 $ 2,874,671 $ IO=IEO=HS R HIOEDQO<SH R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?(0 4-""(01
9(:0&A
BCDE>BCDF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
BCDD 9(:0&A
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
BCDD I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&AQ9(:0&A
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
BCDC I(&$3
7(1#-&$3 98$6-&A
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&A 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
BCDE>BCDF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
BCDE>BCDF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
BCDE>BCDF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
BCDE>BCDF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 BSDCDSTUBST=B V B=WSUBFSCTC V BS=EESCTFS<WW V DSWT<S<FTSW<B V ESTWCSFDDS==C V DESBFESCBTSCTD V BBSU<BS==BSTW< V DSBWTSTDWS<DD V TDSCTCSEFUS=DE V
;-1&6-%& I(&$3 DESFBBSDDT V DSBB=SBWD V BSUTESDDE V > V BSUTESDDE V =BSWWTSB=W V W=SCFTSCET V ESF=ES=D< V DDESU<TS=WE V
!"#$%# '()*+ DESFBBSDDT V ,-(()-(., / (-012-,,2 / 3 / BSUTESDDE V )(-..1-(). / W=SCFTSCET V ESF=ES=D< V ,,2-041-).2 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ?(0 4-""(01
9(:0&A
BCD< E,:3&1
FDGHI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
BCD< E,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
BCD< E,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
BCD< E,:3&1
E33 J:0,1
*(,+6$&+
4%+0$6-(
BCD< 98-3,6+0
FBCCI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
BCD< 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
BCD< 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
BCD< 98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
BCD< E,:3&1 L
98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 DOCCPOQQD QO<D=OCH<OQGG R BSBOHHQOS=D R QOSCQOSQPO<HP R ==CODHS DO=CCOPS=OGHP R Q<SOGB=O=Q< R BOB<SOHBCOS<C R DCODQQOQS=O<PP R
;-1&6-%& N(&$3 GOQBG BHOBDBOHGD R DOCH=ODCS R BSOBSQOSPC R BOCGG =O=P=OCCS R BOHPGOCC< R HOGHHOCD= R GQO<H=OS=P R
uenLon (23) 3,723 28,212,831 $ 1,083,109 $ BSOBSQOSPC R 2,033 3,343,009 $ 2,843,006 $ HOGHHOCD= R GQO<H=OS=P R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ @$0 A$B3(6
9(:0&B
CDEF=CDEG H+I
2(%$3 A$/
>+?+0:+ JK,:3&
./#$01-(0L
CDEE 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
CDEE A(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BQ9(:0&B
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
CDED A(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
A(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
CDEF=CDEG K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
CDEF=CDEG K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
CDEF=CDEG
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
CDEF=CDEG K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ A(&$3 CSEDESTUCSTVC W CVXSUCGSDTD W CSVFFSDTGS<XX W ESXT<S<GTSX<C W FSTXDSGEESVVD W EFSCGFSDCTSDTE W CCSU<CSVVCSTX< W ESCXTSTEXS<EE W TESDTDSFGUSVEF W
;-1&6-%& A(&$3 EXSGFFSFUC W ESVDFSEDE W ESUXXSDUX W = W ESUXXSDUX W VFSTXESEEV W XGSFXCS<TU W FSXXUSEXC W EEXSCEUSGUV W
!"# # $ % '(()* EXSGFFSFUC W +,-./,+.+ 0 +,122,.12 0 3 0 ESUXXSDUX W -/,42+,++- 0 XGSFXCS<TU W FSXXUSEXC W ++2,(+1,51- 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ @$0 A$B3(6
9(:0&B
CDE< F,:3&1
GEHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
GCDDJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ A(&$3 EODDPOQQE QO<ERODI<OQHH S CTCOIIQOTRE S QOTDQOTQPO<IP S RRDOEIT EORDDOPTROHIP S Q<TOHCRORQ< S COC<TOICDOT<D S EDOEQQOQTRO<PP S
;-1&6-%& A(&$3 HOICI CTODEEOTCQ S EOEEROIPH S HDOECQOQQD S CODTQ ROQETOPER S COTHCOPC< S IO<REOIPE S HIOQQTO<EE S
Col l l n (22) 3,828 29,011,927 $ 1,113,843 $ HDOECQOQQD S 2,097 3,719,413 $ 2,932,426 $ IO<REOIPE S HIOQQTO<EE S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A+)) 2+$%8
9(:0&B
CDEF>CDE= G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
CDEE 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
A$-3 7+$3&8%$6+
9(1&1
CDEE I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BP9(:0&B
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
CDED I(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 M
7(1#-&$31
CDEF>CDE= K,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
CDEF>CDE= K,:3&1
Q+,+6$3 Q:0,1
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CDEF>CDE=
K,:3&1 4&$&+
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CDEF>CDE= K,:3&1
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4&$&+H-,+ I(&$3 CREDERSTCRSUC V CUWRTC=RDSD V CRUFFRDS=R<WW V ERWS<R<=SRW<C V FRSWDR=EERUUD V EFRC=FRDCSRDSE V CCRT<CRUUCRSW< V ERCWSRSEWR<EE V SERDSDRF=TRUEF V
;-1&6-%& I(&$3 EWR=FUR=TT V ERUDFRCD< V ERTWWRCS< V > V ERTWWRCS< V UFRSWFRTD< V W=RFWWR=SW V FRWWTRUCS V EEWRCCWRDS= V
!"# # $ % '(()* EWR=FUR=TT V +,-./,(.0 1 +,233,(40 1 5 1 ERTWWRCS< V -/,43/,2.0 1 W=RFWWR=SW V FRWWTRUCS V ++3,((3,.46 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A+)) 2+$%8
9(:0&B
CDE< F,:3&1
GEHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
GCDDJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDE< 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
CDE< F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 EPDDQP==E =P<ERPDI<P=HH S CTCPII=PTRE S =PTD=PT=QP<IQ S RRDPEIT EPRDDPQTRPHIQ S =<TPHCRPR=< S CPC<TPICDPT<D S EDPE==P=TRP<QQ S
;-1&6-%& O(&$3 HPICI CTPDEHPTQT S EPEERPTCE S HDPECTPI=D S CPDT= RP=ETPIEQ S CPTHCP<HE S IP<RCPQQR S HIP=ICPHER S
Col l l n (22) 3,828 29,013,949 $ 1,113,921 $ HDPECTPI=D S 2,097 3,719,814 $ 2,932,631 $ IP<RCPQQR S HIP=ICPHER S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.








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Download this one-pager at
www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org

For more information about the report, Smart, Affordable and Fair call Texas
Impact at 512/472-3903 or email medicaidreporttexasimpact.org


!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/







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Chl l dress (100) 416 3,133,836 $ 121,301 $ HNCPQNEH= R 121 329,734 $ 169,070 $ OS=N=CO R HNPPHNS<C R
Col l l ngsworLh (100) 141 1,072,363 $ 41,243 $ ENEEHN<DS R 72 196,048 $ 100,317 $ CS<NQ<Q R ENOEDNEPO R
Cooke (100) 1,390 10,333,873 $ 403,149 $ EDNSHSNDCC R 772 2,103,671 $ 1,079,608 $ HNE=QNCP= R EONECONHDE R
CoLLl e (100) 68 312,084 $ 19,696 $ QHENP=D R 28 77,317 $ 39,744 $ EEPNC<E R <OSNDOE R
Crosby (100) 293 2,232,083 $ 83,849 $ CNHEPNSHO R 163 430,746 $ 231,104 $ <=EN=QE R CNSSSNP=Q R
ul ckens (100) 128 969,948 $ 37,306 $ ENDDPNCQH R 41 110,738 $ 36,777 $ E<PNQE< R ENEPONP<S R
ll sher (100) 178 1,349,492 $ 31,904 $ ENODENHS< R 71 194,818 $ 99,886 $ CSONPDH R EN<S<NDSS R
ll oyd (100) 311 2,333,387 $ 90,600 $ CNOO<NE=P R 179 488,479 $ 230,430 $ PH=NSHD R HNE=QNEEP R
Carza (100) 417 3,136,849 $ 121,417 $ HNCP=NC<< R 119 324,423 $ 166,336 $ OSDNPQS R HNP<SNDCO R
Pal l (100) 131 1,141,647 $ 43,909 $ ENE=QNQQ< R 76 207,942 $ 106,613 $ HEONQQP R ENQDDNEEH R
Pardeman (100) 188 1,427,811 $ 34,916 $ ENO=CNPCP R 83 223,168 $ 113,447 $ HODN<EQ R EN=CHNHOC R
Paskel l (100) 279 2,114,607 $ 81,331 $ CNESQNSH= R 99 269,874 $ 138,368 $ OD=NCOC R CN<DONEPS R
!ack (100) 432 3,427,932 $ 131,844 $ HNQQSNPS< R 142 387,993 $ 198,930 $ Q=<NSCQ R ONEO<NPCE R
kenL (100) 31 231,944 $ 8,921 $ CODN=<Q R 14 37,733 $ 19,346 $ QPNDPS R CSPNSOO R
kl ng (100) 14 103,429 $ 4,033 $ EDSNO=O R 3 12,714 $ 6,319 $ ESNCHH R EC=NPEP R
MonLague (100) 813 6,173,133 $ 237,303 $ <NOECN<H= R 314 836,787 $ 439,287 $ ENCS<NDPO R PNPD=NPEH R
MoLl ey (100) 47 333,447 $ 13,671 $ H<SNEE= R 19 32,498 $ 26,917 $ PSNOEQ R OO=NQHH R
SLonewal l (100) 61 460,876 $ 17,726 $ OP=N<DC R 23 68,494 $ 33,118 $ EDHN<EC R Q=CNCEH R
1hrockmorLon (100) 64 481,962 $ 18,337 $ QDDNOSS R 23 68,084 $ 34,907 $ EDCNSSE R <DHNOSD R
Wheel er (100) 239 1,813,381 $ 69,743 $ EN==HNEC< R 114 309,637 $ 138,766 $ O<=NOCH R CNHQENQOS R
Wl l barger (100) 693 3,233,381 $ 202,033 $ QNOQQNOHQ R 289 788,704 $ 404,380 $ ENESHND=H R <N<O=NQE= R
?oung (100) 803 6,087,778 $ 234,143 $ <NHCENSCH R 330 900,673 $ 461,788 $ ENH<CNO<D R PN<=ONH=H R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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Archer (100) 382 2,894,782 $ 111,338 $ JQFF<QGEF U 147 401,119 $ 203,660 $ <F<QSS= U JQ<GEQK=K U
8ayl or (100) 131 1,141,647 $ 43,909 $ GQGKTQTT< U 36 131,733 $ 77,806 $ EE=QTTK U GQRGTQGGR U
Cl ay (100) 433 3,436,989 $ 132,192 $ JQT<=QGKG U 138 431,880 $ 221,431 $ <TJQJGG U RQEEEQR=G U
loard (100) 36 427,741 $ 16,432 $ RRRQG=E U 21 36,600 $ 29,019 $ KTQ<G= U TE=QKGE U
knox (100) 168 1,271,174 $ 48,891 $ GQJEFQF<T U 80 218,196 $ 111,872 $ JJFQF<K U GQ<TFQGJJ U
Wl chl La (100) 6,968 32,810,943 $ 2,031,190 $ TRQKREQGJJ U 2,324 6,883,418 $ 3,329,228 $ GFQRGEQ<R< U <TQETRQSS= U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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B=CD>B=C< I,:3&1
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4&$&+F-,+ G(&$3 BQC=CQRSBQRTB U BTVQSB<Q=R= U BQTDDQ=R<QWVV U CQVRWQW<RQVWB U DQRV=Q<CCQTT= U CDQB<DQ=BRQ=RC U BBQSWBQTTBQRVW U CQBVRQRCVQWCC U RCQ=R=QD<SQTCD U
;-1&6-%& G(&$3 CVQ<DTQCDW U CQT=DQCTR U CQSVVQCW< U > U CQSVVQCW< U TDQRVRQ=CC U V<QDVTQWVV U DQVVSQRTB U CCVQBBRQSCW U
!"# # $ % '(()* CVQ<DTQCDW U +,-./,+-0 1 +,233,+45 1 6 1 CQSVVQCW< U -/,030,.++ 1 V<QDVTQWVV U DQVVSQRTB U ++3,((0,2+4 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 4%(&& 4$0)(6,
9(:0&A
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4&$&+M-,+ N(&$3 CO==PO<<C <ODCQO=HDO<GG R BSBOHH<OSQC R <OS=<OS<PODHP R QQ=OCHS COQ==OPSQOGHP R <DSOGBQOQ<D R BOBDSOHB=OSD= R C=OC<<O<SQODPP R
;-1&6-%& N(&$3 GOHBH BSO=CBOSGH R COCCQOHHB R G=OCBHOHB= R BO=S< QO<CSODCP R BOSGBOQBS R HODQBOCPG R GHO<H=OSDG R
Col l l n (22) 3,828 29,012,938 $ 1,113,882 $ G=OCBHOHB= R 2,097 3,719,614 $ 2,932,329 $ HODQBOCPG R GHO<H=OSDG R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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9(:0&B
CD=E>CD=< F+G
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4&$&+G-,+ H(&$3 CR=D=RSTCRSUC V CUWRTC<RDSD V CRUEERDS<RXWW V =RWSXRX<SRWXC V ERSWDR<==RUUD V =ERC<ERDCSRDS= V CCRTXCRUUCRSWX V =RCWSRS=WRX== V S=RDSDRE<TRU=E V
;-1&6-%& H(&$3 =CRSUSRW=< V CRTXXRXDX V WRW=SRS<T V =UR<EXRTCE V CERUXDRSDS V =CURTCTREES V CDCRUWCRDT= V ==RSC=R<T< V C<SR<UTRX=C V
!"#$% '())*+ =R=ESR<EE V ,((-./0 1 (-2).-,)3 1 4 1 =RTDXRCDS V (/-,25-)(5 1 CTRECTRETS V =RXEER<ST V 32-0.2-6/2 1
7"8 9# '())*+ =RDESR=S= V 60-533 1 ,-5/0-/5/ 1 4 1 CREW<RWEW V ()-636-220 1 =XRTETRCDW V TE<RCEW V ,,-2)5-330 1
:9;8 "< '())*+ =DR=XXRTES V ,-.20-5/. 1 5-5(2-3,/ 1 (6-05.-2,5 1 CDR=XXRCUC V 20-)22-53, 1 =UXRCDSRSTD V WR<CTRW=D V ,((-)/6-./6 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 4:1$0 A-05
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98-3,6+0
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4&$&+N-,+ O(&$3 =PDDQP<<= <PE=RPDIEP<HH S CTCPII<PTR= S <PTD<PT<QPEIQ S RRDP=IT =PRDDPQTRPHIQ S <ETPHCRPR<E S CPCETPICDPTED S =DP=<<P<TRPEQQ S
;-1&6-%& O(&$3 IPIEQ E<P=ICPQHR S CPRIHPTQD S ETP<EEPH<R S HPRCH TPEDTPCCQ S QPTCEP<II S =QPRHEPD=C S IQPHDCPHI< S
!ones (100) 1,288 9,739,722 $ 373,374 $ =DP=HRPDTE S 293 797,727 $ 409,006 $ =PCDEP<HH S ==PHQ=PICT S
nol an (100) 742 3,620,877 $ 216,188 $ RPIH<PDER S 336 913,848 $ 469,368 $ =PHIRPQ=E S <PCCCPQI= S
1ayl or (100) 6,833 31,801,836 $ 1,992,378 $ RHP<TQPC=Q S 2,893 7,893,630 $ 4,048,213 $ ==PTQHPIEH S ERP<HIPD<< S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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;-1&6-%& H(&$3 E=QTFWQ=EF U EQET<QSTW U EDQ==RQ=EE U E<QSVSQDWR U =VQ=E=Q=<F U E=WQSEEQVSS U =DFQEW=QTWF U EEQFEDQE=W U =<TQVSTQRVW U
!"#$ &'(()* =E<Q=T< U + , '-.//-01. , + , EQRWWQV<R U '-021-/.. , =QSVVQRWT U EW<QDE= U 3-(.0-..4 ,
!"567" &'(()* ES<QTE< U .4-'28 , 0'2-3'' , + , VETQFEE U .-820-(21 , WQRW<QRD< U RTTQVTR U 0-/(3-31( ,
9: ;<<6"6# &'(()* E=EQTER U + , '(-412 , + , EDQ=<T U 0.(-((/ , EQRRTQ==< U <FQW== U '-0(3-./' ,
=">;?@ &'(()* =QRRTQDE= U .'1-488 , 23.-1'8 , 32/-242 , EQDDDQ=FF U 40-18/-'.. , FWQR=FQ=DE U =QTVVQSF= U /4-/((-418 ,
A ?B "5 &'(()* E<FQE=< U 4/-'32 , 20-2.4 , + , TVQTR= U '-(..-41. , EQWW=Q==E U S=QVS< U 4-43/-432 ,
C$;D;5 &'(()* =TDQS=R U + , 4-.08-404 , + , =QRVSQ=V= U 4-/(0-28' , FQESWQF=V U =RFQT=V U 2-/1(-038 ,
CE55$: < &'(()* WFWQR=E U 43-13/ , '-1('-.// , + , EQ<DEQRWW U /-1(1-0(2 , EDQ<SDQVEF U WDRQD<E U '3-204-'0. ,
FG$?: B 5D &'(()* VDQSDD U '2-403 , 008-404 , + , VVSQ=V= U 18(-304 , EQ=<EQWFT U <EQDWS U '-1'0-3.8 ,
H"I 9?$$5 &'(()* VQT==QWFR U 134-.4. , 4-330-31' , '1-2.4-2.0 , ESQSVEQDDS U 0(-.48-8'8 , E=SQ==WQRTW U <Q===QER= U '13-/.(-448 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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4&$&+A-,+ O(&$3 EPDDQP<<E <PFERPDJFP<II S =T=PJJ<PTRE S <PTD<PT<QPFJQ S RRDPEJT EPRDDPQTRPIJQ S <FTPI=RPR<F S =P=FTPJ=DPTFD S EDPE<<P<TRPFQQ S
;-1&6-%& O(&$3 JPTIQ F<P<DFPRFT S =PFDQPDTT S <DPIEDPFF< S IPRRR TPFTQPE=Q S QPT<DPIE< S EQPFFQPQQD S JQPT<RPEDJ S
Coke (100) 131 991,034 $ 38,117 $ EPD=TPERD S 34 146,831 $ 73,282 $ ===PEEI S EP=REP=FQ S
Concho (100) 279 2,111,394 $ 81,213 $ =PET=PJDT S 48 130,423 $ 66,871 $ ET<P=TF S =PITDPEDF S
Cl asscock (100) 38 442,802 $ 17,031 $ QRTPJII S 28 76,286 $ 39,113 $ EERPQDD S R<RP=II S
Poward (100) 2,027 13,362,326 $ 390,866 $ ERPTRIPITI S 708 1,929,720 $ 989,393 $ =PTETPEER S EJPJ<=PRD< S
l rl on (100) 73 331,244 $ 21,202 $ R<=PQQR S 30 80,798 $ 41,426 $ E==P==Q S FTQPF<D S
8eagan (100) 184 1,391,664 $ 33,326 $ EPQQRPETD S 100 272,334 $ 139,630 $ QEEPTFQ S EPJR<PERQ S
8unnel s (100) 472 3,378,363 $ 137,637 $ IP<EFP=D= S 220 600,838 $ 308,069 $ TDJPT=< S QPF=RPE=T S
SLerl l ng (100) 36 421,716 $ 16,220 $ QI<PTIF S 23 61,321 $ 31,343 $ TIPDFQ S RIEPDDD S
1om Creen (100) 3,633 42,833,423 $ 1,648,286 $ QQPRDIP<DT S 2,343 6,393,349 $ 3,278,987 $ TPF<QPII< S RQPE<JPDQR S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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4&$&+G-,+ H(&$3 BRDCDR=SBR=TB U BTVRSB<RC=C U BRTEERC=<RWVV U DRV=WRW<=RVWB U ER=VCR<DDRTTC U DERB<ERCB=RC=D U BBRSWBRTTBR=VW U DRBV=R=DVRWDD U =DRC=CRE<SRTDE U
;-1&6-%& H(&$3 DWREDCRWEV U =REBBRC=< U TRE=<RS== U BR<CBRE<V U VRDECREDD U V<RE=BRSWT U DECRWTBRSSB U <RVWCR<=V U DSCRC<DRW=D U
!"#$% '())*+ DCRCCDRVSE U ,-./0-0)/ 1 2-3.(-234 1 5 1 =R<SDR=<T U 4(-002-04( 1 V=RDDDRCW< U ERWEERVWW U ((,-2(,-,04 1
67 % % 89:7 8 '())*+ BREEERCV= U 2).-33, 1 ;)4-23) 1 ,-3),-/3; 1 =RTC<RVEV U (/-2,/-004 1 B=RCEERCDS U DRBV<RV<B U 2(-(/)-43) 1
<8=>$% % '())*+ =RSWERW<C U (04-00( 1 ;/(-(;; 1 5 1 VEDRDVV U ,(-///-04) 1 =ERES<RSCT U DRSBVRCCC U /0-0(;-3.0 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ N(&$3 DOCCPO<<D <OEDQOCHEO<== R BSBOHH<OSQD R <OSC<OS<POEHP R QQCODHS DOQCCOPSQO=HP R <ESO=BQOQ<E R BOBESOHBCOSEC R DCOD<<O<SQOEPP R
;-1&6-%& N(&$3 EODQQ PEOEPPOHP< R DO<SPOC== R PHOP=HOH<S R BOQSH <OCHPO=HH R =OE=BOBEH R DCO<DEOEQE R QSODQQOQ=Q R
Comal (100) 3,637 27,362,179 $ 1,060,084 $ BHOEBBOBE= R 1,393 4,343,048 $ 2,227,768 $ EOQ<BOHDE R =QODSQOC<S R
Cl l l espl e (100) 1,008 7,642,104 $ 293,927 $ <OS=EOC=D R 394 1,073,803 $ 331,380 $ DOEB<O=H= R SOQE=OPDP R
kendal l (100) 1,310 11,440,364 $ 440,022 $ DDOHHCOQHQ R 610 1,663,337 $ 832,919 $ BOQDEOPQ< R DPO=S<OCPB R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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;-1&6-%& J(&$3 VTUUGTFWH X HTH=GTUY< X FZTG<ZTVF= X ZTUWZTGGH X UFT=UFTVFW X H=<TUW<THW= X FU<TGWFT<=< X HUTF=YTF<W X UFGTU=HTWY= X
!"#$%&#" ()**+, <WFTYH< X -./*) 0 1/2.-)1 0 -/).323 0 HTFGYTUYZ X 1./*3./4* 0 HFTGYGTZFW X Z<WTHWW X )2.56/.)1) 0
789 :#"%;< ()**+, HWFTGYF X = 0 )./1*.35* 0 = 0 HTW<GTVUG X 6.)64.2// 0 UT=F=TUWY X HVHTU<V X -.261./)) 0
>8?%@#&A ()**+, FGYT<VW X 62/.42/ 0 5*/.1-- 0 = 0 UGWT<== X 5.*62.-)1 0 =TYZYTWYU X F<FTGVU X 2./13.)21 0
B#CC DEFG % ()**+, HZ=T=Y< X )6.55/ 0 )1/.321 0 = 0 H<WTVZ< X ).26*.-44 0 FTZGZTY<F X H=WTZVH X 5./66.4** 0
HG <<#I ()**+, FF=TUH< X 35.-2/ 0 44*.13- 0 = 0 YYGT<V= X 6.424.56) 0 =TZH=TFW= X FW<TY<V X 2.65/.-13 0
J;FG <K ()**+, VTFFF X = 0 = 0 = 0 > X 4-.23/ 0 HUZTF=Y X <TZHW X )4-.))4 0
LEF#"G MN ()**+, FT=V=TZWG X 5-).23) 0 5.163.)36 0 -.6)1.3*5 0 <TV=<TGVW X /*.*-5.)26 0 YGTWG=THVW X =T=VVTH<W X )*4.143.-2/ 0
O#M;% ()**+, V<YTGFW X -6*.-/1 0 )*.64-.462 0 = 0 HGTFY=TYFZ X )-.43-.3-) 0 FUTVZHT=FG X HTUUVTH=U X 56.54*.5*) 0
O"#%G ?G ; ()**+, =UVTVHW X 6.*1- 0 5-4./54 0 = 0 U=YTWUY X 2.-12.5*1 0 HGT=HYT=G= X WYFTFWY X )-.*14.36/ 0
P##F#% ()**+, ZZFTZ<H X = 0 /.61-.465 0 = 0 WTF<=TYFU X )-.56-.22/ 0 FUTG==TGHV X HTFY<TY<F X 5).)-*./1* 0
Q#""#9 9 ()**+, Y=THWU X = 0 5)1.-25 0 = 0 UH<T=ZU X 1-/.5)6 0 HTHVYTV<V X Z<TGGY X ).26*.6-5 0
RE9 R#"?# ()**+, UTHWVTHH< X = 0 6.-56.65) 0 ).242.)63 0 =THHYTUZG X -5.25-.2)) 0 <GTHV=T<VG X UTVFUTGGY X 3-.4/1.45- 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(0%8( B+@C6+D
9(:0&E
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4&$&+ O:0,1
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98-3,6+0
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4&$&+Q-,+ R(&$3 HSGG=S<<H <SIHTSGMIS<LL U FVFSMM<SVTH U <SVG<SV<=SIM= U TTGSHMV HSTGGS=VTSLM= U <IVSLFTST<I U FSFIVSMFGSVIG U HGSH<<S<VTSI== U
;-1&6-%& R(&$3 HGSL<L <MSIHLSVIF U LSGFLSIH= U MHSIL<ST<I U TSGLV HLS<=HS=GM U <SG=TS=HM U FGS<MISMFI U HGFS=F=S=GF U
8rewsLer (100) 329 4,006,306 $ 134,089 $ =SHIGSLVT U 164 448,286 $ 229,842 $ I<MSHFM U =SMLMSTFL U
Cul berson (100) 130 1,133,622 $ 43,678 $ HSH<VSLGG U 69 189,486 $ 97,132 $ FMISILM U HS=ITSVLM U
PudspeLh (100) 213 1,614,371 $ 62,099 $ HSI<ISI<G U 112 303,146 $ 136,433 $ =IHSTVV U FSHLMSFIV U
!eff uavl s (100) 114 864,319 $ 33,231 $ MV<S<IV U 38 103,766 $ 33,202 $ HTISVIM U HSGT=S<LM U
kl nney (100) 202 1,330,228 $ 38,833 $ HSTMVSGML U 71 193,387 $ 99,233 $ FVFSM=F U HSMMHSVFT U
Lovl ng (100) 6 43,184 $ 1,738 $ =ISVFF U 1 1,641 $ 841 $ FS=MF U =VS=GL U
Maverl ck (100) 3,323 26,697,661 $ 1,026,833 $ F<S<F=S=V= U 2,041 3,366,431 $ 2,834,000 $ MS=FGS=TH U LISH==SV=T U
ecos (100) 1,048 7,946,342 $ 303,629 $ MSFTHSV<G U 393 1,071,292 $ 349,267 $ HSIFGSTTM U VSM<FSTFV U
resl dl o (100) 436 3,433,062 $ 132,887 $ LSTM<SV=V U 244 663,661 $ 341,294 $ HSGGISVTT U =STV=SVG= U
8eeves (100) 1,008 7,642,104 $ 293,927 $ <SVLISGLH U 333 914,207 $ 468,727 $ HSLMFSVL= U VSLHMSVIT U
1errel l (100) 32 397,618 $ 13,293 $ =HFSVHH U 19 30,838 $ 26,073 $ <ISVLL U =MVSM== U
val verde (100) 3,072 23,278,746 $ 893,336 $ F=SH<=SGMF U 1,331 4,231,028 $ 2,169,309 $ IS=GGSLL< U LGST<=S=HV U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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9(:0&A
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;-1&6-%& K(&$3 GFUFF<UHV< X GUGWGUEZE X GHUZF<UFVF X GZUW<HUHZW X VGU=YGUHWY X GGVUWW<U=EY X GYVUVY<UE<Z X GFUEHWUFHY X EH<UYEFUZ<F X
!" $%&' ()*+, GFUFF<UHV< X -.-/-.)0) 1 -2.0*3.*4* 1 -0./32.20/ 1 VGU=YGUHWY X --4.//3.5)6 1 GYVUVY<UE<Z X GFUEHWUFHY X )23.6)*.03* 1
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& R(&$3 LSFET HFSLGHSLTH U ESKKVSGFV U HKSG==SV=H U =SFL= GKSLHHSH=L U <SGFVSHK= U EFSV<HSEVT U LTSGKESETV U
Ll aso (20) 8,024 60,816,846 $ 2,339,109 $ HKSG==SV=H U 3,083 13,866,638 $ 7,109,633 $ EFSV<HSEVT U LTSGKESETV U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
EFGG J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DR9(:0&D
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
EFGF J(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
EFGH>EFG< L,:3&1
S+,+6$3 S:0,1
2-"-&+,
4%+0$6-(
EFGH>EFG< L,:3&1
S+,+6$3 S:0,1
*(,+6$&+
4%+0$6-(
EFGH>EFG<
L,:3&1 4&$&+
S:0,1 *(,+6$&+
4%+0$6-(
EFGH>EFG< L,:3&1
S+,+6$3 S:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 ETGFGTUVETUWE X EWYTVE<TFUF X ETWHHTFU<T=YY X GTYU=T=<UTY=E X HTUYFT<GGTWWF X GHTE<HTFEUTFUG X EETV=ETWWETUY= X GTEYUTUGYT=GG X UGTFUFTH<VTWGH X
;-1&6-%& J(&$3 GFTFGGTE=F X GTGVGT<G< X GHT=GET=FV X G=TVYFTVWU X UGTWVUTW=E X GGHTFHGTF<H X GYUTHW<TUEY X GFTEWETV=U X EH<TVGWTUUW X
!" $%&' ()*+, GFTFGGTE=F X -.-/-.0-0 1 -2.3-).3*/ 1 -3./4*./56 1 UGTWVUTW=E X --2.*2-.*02 1 GYUTHW<TUEY X GFTEWETV=U X )20./-5.665 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A$("- B(0C$3+C
9(:0&D
EFG= H,:3&1
IGJKL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EFG= H,:3&1
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EFG= H,:3&1
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EFG= H,:3&1
H33 M:0,1
*(,+6$&+
4%+0$6-(
EFG= 98-3,6+0
IEFFL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EFG= 98-3,6+0
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EFG= 98-3,6+0
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EFG= 98-3,6+0
H33 M:0,1
*(,+6$&+
4%+0$6-(
EFG= H,:3&1 O
98-3,6+0
H33 M:0,1
*(,+6$&+
4%+0$6-(
4&$&+P-,+ Q(&$3 GRFFSR<<G <R=GTRFK=R<JJ U EVERKK<RVTG U <RVF<RV<SR=KS U TTFRGKV GRTFFRSVTRJKS U <=VRJETRT<= U ERE=VRKEFRV=F U GFRG<<R<VTR=SS U
;-1&6-%& Q(&$3 KRFEK =FRKSFRF<< U ERJSFRFFJ U =JRGKFRFKF U TRFK= GJRK<GRVTT U <RGGERJTG U EFRVKSRJF= U KSRG=SRJK< U
Ll aso (20) 8,028 60,840,077 $ 2,340,003 $ =JRGKFRFKF U 3,086 13,871,933 $ 7,112,331 $ EFRVKSRJF= U KSRG=SRJK< U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ *$6-1$ *@6A:+B
9(:0&C
DEFG=DEF< H+I
2(%$3 J$/
>+?+0:+ KL,:3&
./#$01-(0M
DEFF 9(:0&C
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
DEFF J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CR9(:0&C
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
DEFE J(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
DEFG=DEF< L,:3&1
S+,+6$3 S:0,1
2-"-&+,
4%+0$6-(
DEFG=DEF< L,:3&1
S+,+6$3 S:0,1
*(,+6$&+
4%+0$6-(
DEFG=DEF<
L,:3&1 4&$&+
S:0,1 *(,+6$&+
4%+0$6-(
DEFG=DEF< L,:3&1
S+,+6$3 S:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 DTFEFTUVDTUWD X DWYTVD<TEUE X DTWGGTEU<TZYY X FTYUZTZ<UTYZD X GTUYET<FFTWWE X FGTD<GTEDUTEUF X DDTVZDTWWDTUYZ X FTDYUTUFYTZFF X UFTEUETG<VTWFG X
;-1&6-%& J(&$3 FETEWETVDY X FTFVZTGUV X FGTZ<ETWFE X F<TEGYTDUY X UFT<FYT<GY X FFGTGVDTVGV X FYGTFYGTDWY X FETDVUTWYV X DGYTYV<TZ<D X
!" $%&' ()*+, FETEWETVDY X -.-/0.12/ 3 -1.04*.5-* 3 -4.*16.)26 3 UFT<FYT<GY X --1.1/)./1/ 3 FYGTFYGTDWY X FETDVUTWYV X )16.6/4.04) 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ *$6-1$ *@6A:+B
9(:0&C
DEFG H,:3&1
IFJKL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1
H33 M:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
IDEEL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
H33 M:0,1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1 O
98-3,6+0
H33 M:0,1
*(,+6$&+
4%+0$6-(
4&$&+P-,+ Q(&$3 FREESR<<F <RGFTREKGR<JJ U DVDRKK<RVTF U <RVE<RV<SRGKS U TTERFKV FRTEERSVTRJKS U <GVRJDTRT<G U DRDGVRKDERVGE U FERF<<R<VTRGSS U
;-1&6-%& Q(&$3 KRETV GFREKFRFTE U DRJSVRD<T U GJRSJERSDT U TRFE< FJRVDGRVDF U <RFSERTJJ U DFREG<RSTS U KSRSV<RK<V U
Ll aso (20) 8,039 61,081,130 $ 2,349,273 $ GJRSJERSDT U 3,107 13,926,921 $ 7,140,333 $ DFREG<RSTS U KSRSV<RK<V U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(+ *((,B
9(:0&B
CDEF>CDE< G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
CDEE 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
A$-3 7+$3&8%$6+
9(1&1
CDEE I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BP9(:0&B
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
CDED I(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 M
7(1#-&$31
CDEF>CDE< K,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
CDEF>CDE< K,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
CDEF>CDE<
K,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
CDEF>CDE< K,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 CREDERSTCRSUC V CU=RTC<RDSD V CRUFFRDS<RW== V ER=SWRW<SR=WC V FRS=DR<EERUUD V EFRC<FRDCSRDSE V CCRTWCRUUCRS=W V ERC=SRSE=RWEE V SERDSDRF<TRUEF V
;-1&6-%& I(&$3 EDRDSWR=TE V ERETFR<W= V EFRWUDRDCE V E<RDCFRFC= V SERW<FRFF= V EEFRSSSRDFF V E=SRTC<RDET V EDRC<TRCES V CF=RUUDRDUC V
!" $%&' ()*+, EDRDSWR=TE V -.-/0.123 4 -0.25*.*)- 4 -1.*)0.0)3 4 SERW<FRFF= V --0.666.*00 4 E=SRTC<RDET V EDRC<TRCES V )03.55*.*5) 4
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(+ *((,B
9(:0&B
CDEF G,:3&1
HEI=J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1
G33 K:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
HCDDJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CDEF 98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
CDEF G,:3&1 M
98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 EPDDQP<<E <PFERPD=FP<II S CTCP==<PTRE S <PTD<PT<QPF=Q S RRDPE=T EPRDDPQTRPI=Q S <FTPICRPR<F S CPCFTP=CDPTFD S EDPE<<P<TRPFQQ S
;-1&6-%& O(&$3 =PDQ= FDPTTRP=QE S CPIQRPTTQ S FIPIQEP=IR S RPDTT EIPTD<PQ<E S <PEIDPRFD S CEPDI=PDIE S =QPI<TP=FF S
Ll aso (20) 8,048 60,993,841 $ 2,343,994 $ FIPIQEP=IR S 3,099 13,907,471 $ 7,130,360 $ CEPDI=PDIE S =QPI<TP=FF S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 79 - kepresentat|ve Ioe C. |ckett
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 10,068,037 5 1,198,47S 5 14,69S,482 5 17,077,2S7 5 31,772,738 5 114,687,834 5 184,497,768 5 10,311,111 5 249,321,33S 5
!" $%&' ()*+, 10,068,037 5 -.-/0.123 4 -1.5/3.10) 4 -2.*22.)32 4 31,772,738 5 --1.502.061 4 184,497,768 5 10,311,111 5 )1/.6)-.663 4
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 79 - kepresentat|ve Ioe C. |ckett
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 8,073 61,18S,119 5 2,3S3,274 5 63,S38,393 5 S,11S 13,9S0,627 5 7,1S2,687 5 21,103,31S 5 84,641,708 5
Ll aso (20) 8,073 61,183,119 $ 2,333,274 $ 63,S38,393 5 3,113 13,930,627 $ 7,132,687 $ 21,103,31S 5 84,641,708 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 80 - kepresentat|ve 1racy C. k|ng
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 9,0S9,003 5 3,147,329 5 10,894,S81 5 6,S22,SS6 5 17,417,137 5 129,0S9,077 5 207,616,718 5 11,603,170 5 280,S63,162 5
!" ##" $ &'(()* 603,202 5 '+(,-./ 0 ','./,1(' 0 2 0 1,1S3,801 5 1,1/(,1'3 0 14,206,088 5 793,942 5 '4,'4-,3'4 0
56" 7 &'(()* 892,28S 5 3.,/(+ 0 ',3.8,-'' 0 '(1,.+/ 0 1,S6S,234 5 '8,/.-,/// 0 26,313,963 5 1,470,620 5 /.,..4,3'/ 0
9:;< => &'(()* 1,7SS,731 5 +1.,8'+ 0 ',448,883 0 +,'/3,18+ 0 4,131,S26 5 +',8/8,8+3 0 34,806,733 5 1,94S,260 5 3-,(/8,'/' 0
?>@@ &/8)* 4,639,978 5 -.3,8(/ 0 ',-1+,/88 0 3,+-4,'-' 0 6,061,S37 5 .1,-48,.'+ 0 94,S8S,666 5 S,286,1S2 5 '+-,1'1,31+ 0
A;B;$; &'(()* 679,981 5 ',-.(,1/+ 0 3,+'-,+-1 0 2 0 4,217,278 5 '+,883,8.+ 0 20,373,S6S 5 1,138,627 5 +-,./',131 0
A;:;< ; &'(()* 487,826 5 '4(,++- 0 +1-,-8' 0 2 0 287,761 5 '(,--/,'3+ 0 17,330,701 5 968,S69 5 +/,3'4,184 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 80 - kepresentat|ve 1racy C. k|ng
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 9,08S 68,8S2,072 5 2,648,1S7 5 71,S00,229 5 S,9S0 16,227,491 5 8,320,068 5 24,S47,SS9 5 96,047,788 5
ul mml L (100) 622 4,711,173 $ 181,199 $ 4,892,374 5 324 883,837 $ 433,166 $ 1,337,023 5 6,229,396 5
lrl o (100) 1,131 8,726,317 $ 333,633 $ 9,062,1S3 5 430 1,228,376 $ 629,806 $ 1,8S8,182 5 10,920,33S 5
uval de (100) 1,323 11,342,980 $ 443,961 $ 11,986,941 5 786 2,143,814 $ 1,099,164 $ 3,242,978 5 1S,229,919 5
Webb (36) 4,139 31,367,308 $ 1,206,443 $ 32,S73,9S1 5 3,447 9,400,262 $ 4,819,630 $ 14,219,912 5 46,793,863 5
ZapaLa (100) 891 6,736,499 $ 239,863 $ 7,016,36S 5 336 1,460,317 $ 748,828 $ 2,209,34S 5 9,22S,709 5
Zaval a (100) 738 3,747,392 $ 221,034 $ S,968,446 5 407 1,110,663 $ 369,434 $ 1,680,119 5 7,648,S6S 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 81 - kepresentat|ve 1ryon D. Lew|s
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 12,646,647 5 2S2,974 5 S0,S79,180 5 8,303,610 5 S8,882,790 5 102,711,8SS 5 16S,232,068 5 9,234,400 5 223,286,602 5
!"#$%&' )*++,- 1,160,386 5 *./01. 2 *+/345/461 2 173/+4. 2 10,6S0,629 5 **/.41/7.4 2 18,747,677 5 1,047,760 5 34/110/6+* 2
89:;$ )*++,- 10,201,S19 5 < 2 10/3.1/334 2 6/7**/440 2 42,174,779 5 6./76./+*6 2 123,830,949 5 6,920,S97 5 *.6/117/*15 2
=>$# )*++,- 796,2S9 5 3++/304 2 1/3+1/*0. 2 < 2 3,203,146 5 5/1.6/5*5 2 13,461,268 5 7S2,316 5 *5/*7+/7+4 2
=? "@A %$ )*++,- 488,484 5 1./371 2 3/540/316 2 < 2 2,8S4,237 5 4/6*0/+4. 2 9,192,17S 5 S13,727 5 *3/03*/547 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 81 - kepresentat|ve 1ryon D. Lew|s
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 7,230 S4,796,022 5 2,107,S39 5 S6,903,S61 5 3,9S2 10,777,720 5 S,S2S,892 5 16,303,612 5 73,207,173 5
Andrews (100) 820 6,217,303 $ 239,127 $ 6,4S6,432 5 392 1,068,421 $ 347,793 $ 1,616,21S 5 8,072,647 5
LcLor (100) 3,418 41,066,141 $ 1,379,467 $ 42,64S,608 5 3,099 8,432,213 $ 4,333,371 $ 12,78S,784 5 SS,431,392 5
Ward (100) 389 4,464,169 $ 171,699 $ 4,63S,868 5 266 726,362 $ 372,416 $ 1,098,778 5 S,734,646 5
Wl nkl er (100) 402 3,048,407 $ 117,246 $ 3,16S,6S4 5 193 330,724 $ 272,110 $ 802,834 5 3,968,488 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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=DEF>=DEG H+I
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!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+N-,+ A(&$3 EODDPOQQE QOFEROD<FOQII S =T=O<<QOTRE S QOTDQOTQPOF<P S RRDOE<T EORDDOPTROI<P S QFTOI=RORQF S =O=FTO<=DOTFD S EDOEQQOQTROFPP S
;-1&6-%& A(&$3 FOQ<< REOPPFOI<T S EOTQ<OQDQ S RIOP=RODTF S IOITD TO=PPOET< S POQITOFII S EIOT<IO<IE S FQOPD<OT=Q S
Crane (100) 233 1,913,797 $ 73,683 $ EOT<TOP<= S 124 338,778 $ 173,696 $ RE=OPQP S =ORDEOTRF S
uawson (100) 818 6,202,243 $ 238,348 $ FOPPDOQTE S 326 890,009 $ 436,320 $ EOIPFOI=T S QOQ<QOE=D S
MarLl n (100) 234 1,777,233 $ 68,333 $ EO<PROR<T S 126 343,699 $ 176,220 $ RETOTET S =OIFRORDQ S
Ml dl and (100) 3,311 40,232,831 $ 1,348,186 $ PEO<DEODEQ S 2,730 7,443,723 $ 3,817,330 $ EEO=FIO=RI S RIODFPO=QD S
upLon (100) 171 1,298,284 $ 49,934 $ EOIP<O=E< S 83 223,988 $ 113,868 $ IPEO<RF S EOFTDODQP S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
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9$6+ 9(1&1
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4&$&+I-,+ J(&$3 CTEDET=UCT=VC W CV<TUCGTD=D W CTVFFTD=GTX<< W ET<=XTXG=T<XC W FT=<DTGEETVVD W EFTCGFTDC=TD=E W CCTUXCTVVCT=<X W ETC<=T=E<TXEE W =ETD=DTFGUTVEF W
;-1&6-%& J(&$3 ECTV=DTF<F W =CXTXVC W CXTGXFT=VU W EXTC=CTVCF W FCTUUXT<<= W EVCT=D=TVX= W CFVTDEDTDEE W E=TXUCTU<X W ==ETDUFTXFV W
!"#$%& ()**+, XFTEXE W -*./*- 0 -1./2- 0 3 0 C=TFXC W 145.656 0 XCXTG=U W =VTDCG W 4/2.5/6 0
789 &%: ()**+, ETE==TEGF W --6.;** 0 2.)*;.522 0 3 0 XTEDGTUXX W )-.*2*./54 0 EUTFDETXXX W ETD<FT=ED W -2.-)4./;* 0
<=>>"?@ (/*+, <TCD=TC=U W /-.14/ 0 2.51/.*4; 0 )2.-1-.6-/ 0 C=TEXXTXED W )*/.1;;.;21 0 EXGTUECTDDG W UT=<FTEGV W --2.5*4.)/- 0
<A&& ()**+, FVGTFGE W 16.15) 0 415.611 0 3 0 <=UTV== W /.)-;.//2 0 XTX=UT<DC W =GETD<C W 4.5;-.;*; 0
B9 C?D%E E ()**+, F<<T<=F W -.;;2 0 -.4*;./14 0 3 0 CT<DGTF=< W 4.4*4.--5 0 EFTEXUTGVX W GUETUEC W )5.)/4.1-) 0
F?=##A ()**+, ETCXVTVEF W 3 0 4.*/).)65 0 3 0 <TDFETEVU W )-.25-.44/ 0 CDTFE<TU<E W ETEFETEXV W -;.651.--) 0
G%##A ()**+, UE<TDUD W 3 0 -.*)*.;)6 0 3 0 CTDEDTGEV W 5.4/;.)/4 0 EVT<FETDXD W <<VT=EG W -)./*2.4/* 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 98$63+1 A+66B
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4&$&+L-,+ M(&$3 ENDDONPPE PNFEQND<FNP== R CSCN<<PNSQE R PNSDPNSPONF<O R QQDNE<S ENQDDNOSQN=<O R PFSN=CQNQPF R CNCFSN<CDNSFD R EDNEPPNPSQNFOO R
;-1&6-%& M(&$3 EDNPCE <ENCQCN<=Q R =NECQNEDS R <ON=PPNSOO R =NP== EDNE<DNPPP R QNCESN<=E R EQNODDNFD< R SSNPP<NQQC R
8orden (100) 27 207,846 $ 7,994 $ CEQN<OD R 10 27,480 $ 14,089 $ OENQFS R CQPNODS R
Cal nes (100) 849 6,434,187 $ 247,469 $ FNF<ENFQF R 463 1,264,039 $ 648,101 $ ENSECNEFD R <NQS=N<EF R
Lubbock (40) 7,347 33,684,772 $ 2,141,722 $ QPN<CFNOSO R 2,281 6,220,443 $ 3,189,311 $ SNODSNPQO R FPNC=FNCO< R
Lynn (100) 291 2,201,962 $ 84,691 $ CNC<FNFQ= R 148 402,760 $ 206,301 $ FDSNCFD R CN<SQNSE= R
Ml Lchel l (100) 620 4,699,126 $ 180,736 $ ON<PSN<FE R 137 427,368 $ 219,118 $ FOFNO<F R QNQCFN=OP R
Scurry (100) 893 6,771,361 $ 260,443 $ PND=CNDDQ R 371 1,011,001 $ 318,333 $ ENQCSN=QQ R <NQFEN=FE R
1erry (100) 693 3,233,381 $ 202,033 $ QNOQQNO=Q R 303 827,667 $ 424,337 $ ENCQCNDCO R FNPDPNOQS R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(80 B6:33(
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4&$&+I-,+ J(&$3 DRFEFRSTDRSUD V DU<RTDGRESE V DRU==RESGRW<< V FR<SWRWGSR<WD V =RS<ERGFFRUUE V F=RDG=REDSRESF V DDRTWDRUUDRS<W V FRD<SRSF<RWFF V SFRESER=GTRUF= V
;-1&6-%& J(&$3 FDR=DTREWF V W=RDF< V FERUEWRFFW V D=RUT=RUUU V SURFEERWGD V FU<RF=WRT<U V DU=R=FERDTW V F=RDF<RS== V S=SRGTGRGS= V
!"##$%& ()*+, FDR=DTREWF V )-./01 2 0*.3*).00) 2 /-.34-.333 2 SURFEERWGD V 031.0-).413 2 DU=R=FERDTW V F=RDF<RS== V 5-5.646.65- 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(80 B6:33(
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4&$&+N-,+ O(&$3 FPEE=PQQF QPGFRPE<GPQJJ S DTDP<<QPTRF S QPTEQPTQ=PG<= S RREPF<T FPREEP=TRPJ<= S QGTPJDRPRQG S DPDGTP<DEPTGE S FEPFQQPQTRPG== S
;-1&6-%& O(&$3 FFPFJD <=PJQEPDR< S JPD=RPEFE S <QPGFRPDG< S JP=RG TP=D=P<=G S =P<JDPDR= S F=PDRQPFEE S FEFP<QDPJGQ S
Lubbock (60) 11,132 84,370,238 $ 3,243,010 $ <QPGFRPDG< S 3,436 9,424,846 $ 4,832,234 $ F=PDRQPFEE S FEFP<QDPJGQ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A8-3 4&+#8+01(0
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;-1&6-%& J(&$3 EFT=FDTFXC W ETXUUTCFU W <TCDETCDE W XTC<XTVFX W EFTF<<TEF< W <FTXUFT<DF W EUXTE=ETXDF W GTXDVTEXG W E<UTV<<TXGF W
!"#$ &'() *+,-. EDTXE<TFCU W +/012/1,2 3 0/,0+/445 3 6/+,5/025 3 XTDDXTC<E W 12/156/7+5 3 GXTUU<T<<= W FTCXXTU<X W +46/+84/882 3
9:;<="( *+44-. V==TCVD W 1+/574 3 0/047/++8 3 > 3 CTCDVTEEX W 8/1,2/577 3 EDTFUXT=GD W =<UTCGU W +1/+46/125 3
?@:#$"( *+44-. CTVXXTGFV W 611/+88 3 6/+2+/4,4 3 6/+4+/82+ 3 XTCGCTG=E W 64/876/074 3 FVTUGXTEFV W CTG=VT=DG W 88/201/566 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A8-3 4&+#8+01(0
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4&$&+M-,+ N(&$3 EODDPOQQE QOFE=OD<FOQII R CSCO<<QOS=E R QOSDQOSQPOF<P R ==DOE<S EO=DDOPS=OI<P R QFSOIC=O=QF R COCFSO<CDOSFD R EDOEQQOQS=OFPP R
;-1&6-%& N(&$3 =OS=< P=OE=CODP< R EOQIFOFEQ R PFO<<<OFF= R IOEFC <OFCCOE<S R POPCDOQCE R EIODPCOSED R =SOSIEO=QF R
lorL 8end (18) 3,340 23,316,316 $ 973,704 $ CFOCSDODCD R 1,849 3,042,037 $ 2,383,133 $ QOFCQOESI R IIOSEQOCEI R
!ackson (100) 437 3,461,087 $ 133,119 $ IO=SPOCD= R 243 662,380 $ 339,612 $ EODDEOSSE R PO=SFOESQ R
WharLon (100) 2,161 16,374,646 $ 629,794 $ EQODDPOPPD R 1,070 2,917,732 $ 1,493,974 $ POPEIOQCF R CEOPE<OEFF R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 86 - kepresentat|ve Iohn 1. Sm|thee
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 13,40S,034 5 S36,633 5 8,34S,7S9 5 - 5 8,34S,7S9 5 110,227,081 5 177,321,776 5 9,910,063 5 239,624,048 5
!"# # "$ &'(()* 601,946 5 +,-'. / -01,213 / 4 / 87S,2S6 5 +,.'0,.2- / 7,911,447 5 442,1S1 5 '(,3.','+3 /
!5"6 7$8 9: &'(()* 1,3S6,447 5 .-( / +,201,;(2 / 4 / 4,27S,302 5 '+,11(,1'0 / 23,407,346 5 1,308,177 5 ;',3;',11; /
<"=9# 5> &'(()* 491,4S7 5 1,-(( / ',(32,(30 / 4 / 1,062,067 5 +,..3,.03 / 8,038,611 5 449,2S8 5 '(,-32,..( /
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 86 - kepresentat|ve Iohn 1. Sm|thee
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| 7,7S9 S8,80S,340 5 2,261,744 5 61,067,084 5 3,4S0 9,407,844 5 4,823,S37 5 14,231,381 5 7S,298,466 5
ual l am (100) 346 2,623,678 $ 100,911 $ 2,724,S89 5 172 467,972 $ 239,936 $ 707,909 5 3,432,498 5
ueaf Sml Lh (100) 1,024 7,762,394 $ 298,361 $ 8,061,1SS 5 624 1,702,091 $ 872,686 $ 2,S74,777 5 10,63S,932 5
ParLl ey (100) 332 2,663,830 $ 102,333 $ 2,768,383 5 101 276,436 $ 141,733 $ 418,169 5 3,186,SS1 5
Cl dham (100) 79 399,440 $ 23,033 $ 622,49S 5 30 136,988 $ 70,233 $ 207,223 5 829,718 5
armer (100) 333 4,039,441 $ 133,363 $ 4,194,804 5 309 842,432 $ 431,927 $ 1,274,3S9 5 S,469,163 5
8andal l (100) 3,423 41,114,337 $ 1,381,321 $ 42,69S,6S8 5 2,193 3,981,926 $ 3,067,019 $ 9,048,94S 5 S1,744,603 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe
flrsL full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln
lnLerpreLlng Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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;-1&6-%& P(&$3 <Q=UR IIQISFQF=< T FQSILQSRU T IUQFHSQ<F= T RQFF< HHQSFUQUFH T SQUHHQSSI T H=QRRHQR== T <IQIS=QLGR T
Carson (100) 238 1,931,944 $ 73,073 $ FQGF=QGHU T 103 286,689 $ 146,990 $ RLLQI=U T FQRIGQIUU T
PuLchl nson (100) 1,037 7,838,986 $ 302,269 $ <QHIHQFSS T 446 1,217,302 $ 624,128 $ HQ<RHQRLH T HGQGGFQI<I T
Moore (100) 1,223 9,283,783 $ 337,069 $ UQIRGQ<SR T 667 1,818,161 $ 932,197 $ FQ=SGQLS< T HFQLUHQFHF T
oLLer (100) 6,133 46,482,183 $ 1,787,776 $ R<QFIUQUIH T 2,930 7,989,372 $ 4,096,369 $ HFQG<SQURH T IGQLSSQUGF T
Sherman (100) 142 1,073,377 $ 41,361 $ HQHHIQ=L= T 80 218,196 $ 111,872 $ LLGQGI< T HQRRIQ<GS T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
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Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.







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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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ArmsLrong (100) 77 384,378 $ 22,476 $ ECEO<RR S 28 77,317 $ 39,744 $ DDQOBED S QBPODDR S
8al l ey (100) 338 2,714,046 $ 104,386 $ BO<D<OPHH S 217 391,013 $ 303,022 $ <TPOCHQ S HOQDBOPQC S
8rl scoe (100) 73 331,244 $ 21,202 $ RQBOPPR S 30 81,208 $ 41,637 $ DBBO<PR S ETROBTC S
CasLro (100) 411 3,114,677 $ 119,793 $ HOBHPOPQB S 243 662,790 $ 339,822 $ DOCCBOEDB S POBHQOC<P S
Cochran (100) 139 1,207,916 $ 46,438 $ DOBRPOHQR S 87 236,242 $ 121,123 $ HRQOHEQ S DOEDDOQPD S
uonl ey (100) 138 1,198,879 $ 46,111 $ DOBPPOTTC S 37 134,214 $ 79,067 $ BHHOB<D S DOPQ<OBQD S
Cray (100) 1,123 8,327,708 $ 327,989 $ <O<RROETQ S 444 1,211,130 $ 620,974 $ DO<HBODBP S DCOE<QO<BD S
Pal e (100) 2,022 13,323,367 $ 389,360 $ DROTDBOQBQ S 1,017 2,774,613 $ 1,422,384 $ PODTQODTQ S BCODCTOTBP S
Pansford (100) 264 1,997,128 $ 76,813 $ BOCQHOTPD S 132 413,423 $ 211,968 $ EBROHTB S BOETTOHHH S
Pemphl l l (100) 174 1,316,338 $ 30,629 $ DOHEEOT<Q S 89 242,804 $ 124,489 $ HEQOBTH S DOQHPOB<C S
Pockl ey (100) 1,193 9,037,866 $ 348,379 $ TOPCEOBPR S 371 1,338,341 $ 799,086 $ BOHRQOEBQ S DDOQEHO<QB S
Lamb (100) 701 3,310,614 $ 204,234 $ RORDPO<ET S 383 1,030,783 $ 338,732 $ DOR<TORHQ S QODCPOPCE S
Ll pscomb (100) 134 1,163,743 $ 44,836 $ DOBDCOR<D S 74 202,200 $ 103,671 $ HCRO<QD S DORDEOPRB S
Cchl l Lree (100) 309 3,833,693 $ 148,296 $ POCCHOT<T S 297 810,831 $ 413,733 $ DOBBEOR<E S ROBHCORQR S
8oberLs (100) 39 293,201 $ 11,334 $ HCEORRR S 16 42,633 $ 21,870 $ EPORBR S HQDOC<C S
Swl sher (100) 412 3,120,701 $ 120,027 $ HOBPCOQB< S 183 300,374 $ 236,349 $ QREOTBB S HOTTQOERD S
?oakum (100) 410 3,103,640 $ 119,448 $ HOBBROC<< S 236 642,283 $ 329,308 $ TQDORTD S PODTEOEQ< S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(,-+ 2$:B+0B+65
9(:0&C
DEFG>DEFH I+J
2(%$3 K$/
?+@+0:+ LM,:3&
./#$01-(0N
DEFF 9(:0&C
!0,-5+0&
7+$3&8%$6+ O
P06+-"B:61+,
A$-3 7+$3&8%$6+
9(1&1
DEFF K(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
P06+-"B:61+,
7+$3&8%$6+
./#+0,-&:6+1
DEFE K(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
K(&$3
P06+-"B:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 O
7(1#-&$31
DEFG>DEFH M,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
DEFG>DEFH M,:3&1
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M,:3&1 4&$&+
R:0,1 *(,+6$&+
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4&$&+J-,+ K(&$3 DSFEFST=DSTUD V DU<S=DHSETE V DSUGGSETHSW<< V FS<TWSWHTS<WD V GST<ESHFFSUUE V FGSDHGSEDTSETF V DDS=WDSUUDST<W V FSD<TSTF<SWFF V TFSETESGH=SUFG V
;-1&6-%& K(&$3 F<SHGUSGHD V FSUEGSF<E V FS=<<SDED V > V FS=<<SDED V UGST<TS=U< V <HSG<HSDFT V GS<<=SGT< V FF<SDDUS=HW V
!"# # $ % '(()* F<SHGUSGHD V +,-./,+0. 1 +,200,(.( 1 3 1 FS=<<SDED V -/,404,2-0 1 <HSG<HSDFT V GS<<=SGT< V ++0,((-,256 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(,-+ 2$:B+0B+65
9(:0&C
DEFG H,:3&1
IFJ<K LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1
H33 L:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
IDEEK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DEFG 98-3,6+0
H33 L:0,1
*(,+6$&+
4%+0$6-(
DEFG H,:3&1 N
98-3,6+0
H33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+O-,+ P(&$3 FQEERQSSF SQGFTQE<GQSJJ U D=DQ<<SQ=TF U SQ=ESQ=SRQG<R U TTEQF<= FQTEEQR=TQJ<R U SG=QJDTQTSG U DQDG=Q<DEQ=GE U FEQFSSQS=TQGRR U
;-1&6-%& P(&$3 JQ<D< D=QEFJQRRJ U FQFFTQ=ED U JEQFD=QJRT U DQE=S TQSF=QSFR U DQ=JDQT<E U <QGTDQD=R U J<QS<FQGJ= U
Col l l n (22) 3,828 29,013,443 $ 1,113,902 $ JEQFD=QJRT U 2,097 3,719,714 $ 2,932,380 $ <QGTDQD=R U J<QS<FQGJ= U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 2(0 A:60$"
9(:0&B
C=DE>C=DF G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
C=DD 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
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9(1&1
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N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
C=D= I(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
C=DE>C=DF K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
C=DE>C=DF K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
C=DE>C=DF
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
C=DE>C=DF K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 CSD=DST<CSTUC V CUWS<CFS=T= V CSUEES=TFSXWW V DSWTXSXFTSWXC V ESTW=SFDDSUU= V DESCFES=CTS=TD V CCS<XCSUUCSTWX V DSCWTSTDWSXDD V TDS=T=SEF<SUDE V
;-1&6-%& I(&$3 DTSFCCSFCE V > V CTSX<XSDCU V DTSCTXS<FX V TXS<TTSD=D V F=S<FFSEDD V DDESDWDS=C= V XSTWDSCWF V DUESC<WSX<C V
!"##"$% '()* DTSFCCSFCE V + , -./0(0/1-2 , 1./-.0/(30 , TXS<TTSD=D V 34/(33/511 , DDESDWDS=C= V XSTWDSCWF V 125/-(6/0(- ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 2(0 A:60$"
9(:0&B
C=DE F,:3&1
GDHIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
C=DE F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
C=DE F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
C=DE F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
GC==J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
C=DE 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
C=DE F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 DP==QPRRD RPEDSP=IEPRHH T C<CPIIRP<SD T RP<=RP<RQPEIQ T SS=PDI< DPS==PQ<SPHIQ T RE<PHCSPSRE T CPCE<PIC=P<E= T D=PDRRPR<SPEQQ T
;-1&6-%& O(&$3 QP<<E HRPIESP<C< T DPQSEPHIC T H<PHCCPHDD T HPC<E IP<IRPEDQ T QPE=IP=R< T DHPS<SPE<H T SCP<DIP==H T
1arranL (9) 4,996 37,863,929 $ 1,436,382 $ H<PHCCPHDD T 3,296 8,987,614 $ 4,608,079 $ DHPS<SPE<H T SCP<DIP==H T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 4&+#8$0-+ A3-%B
9(:0&C
DE=F>DE=G H+I
2(%$3 J$/
?+@+0:+ KL,:3&
./#$01-(0M
DE== 9(:0&C
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
DE== J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CR9(:0&C
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
DE=E J(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
DE=F>DE=G L,:3&1
S+,+6$3 S:0,1
2-"-&+,
4%+0$6-(
DE=F>DE=G L,:3&1
S+,+6$3 S:0,1
*(,+6$&+
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DE=F>DE=G
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S+,+6$3 S:0,1
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4&$&+I-,+ J(&$3 DT=E=TU<DTUVD W DVXT<DGTEUE W DTVFFTEUGTYXX W =TXUYTYGUTXYD W FTUXETG==TVVE W =FTDGFTEDUTEU= W DDT<YDTVVDTUXY W =TDXUTU=XTY== W U=TEUETFG<TV=F W
;-1&6-%& J(&$3 =FTE=YTDU< W > W DFTDEDT<Y= W =UTVDET=E= W UGTGDUTEY= W GDTF<VTVFF W ==YTYDUTDUF W YTV=GTGGY W =VGTV<XT<XD W
!"##"$% '()* =FTE=YTDU< W + , -./-0-/(12 , 23/4-0/202 , UGTGDUTEY= W 5-/.(4/4.. , ==YTYDUTDUF W YTV=GTGGY W 245/4(6/(6- ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 4&+#8$0-+ A3-%B
9(:0&C
DE=F G,:3&1
H=IJK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DE=F G,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DE=F G,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DE=F G,:3&1
G33 L:0,1
*(,+6$&+
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DE=F 98-3,6+0
HDEEK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DE=F 98-3,6+0
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DE=F 98-3,6+0
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DE=F 98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
DE=F G,:3&1 N
98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+O-,+ P(&$3 =QEERQSS= SQF=TQEJFQSII U D<DQJJSQ<T= U SQ<ESQ<SRQFJR U TTEQ=J< =QTEEQR<TQIJR U SF<QIDTQTSF U DQDF<QJDEQ<FE U =EQ=SSQS<TQFRR U
;-1&6-%& P(&$3 TQ=EI IJQFSTQJRD U =QRJSQTID U REQ=FIQISR U IQIFF <Q=S<QJR< U RQSEFQFR= U =IQJJFQR<E U TRQER<QJFT U
1arranL (9) 3,103 38,673,842 $ 1,487,332 $ REQ=FIQISR U 3,366 9,179,849 $ 4,706,641 $ =IQJJFQR<E U TRQER<QJFT U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(0$&8$0 4&-%B3$0,
9(:0&C
=DEF>=DEG H+I
2(%$3 J$/
?+@+0:+ KL,:3&
./#$01-(0M
=DEE 9(:0&C
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
A$-3 7+$3&8%$6+
9(1&1
=DEE J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
=DED J(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 N
7(1#-&$31
=DEF>=DEG L,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
=DEF>=DEG L,:3&1
R+,+6$3 R:0,1
*(,+6$&+
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=DEF>=DEG
L,:3&1 4&$&+
R:0,1 *(,+6$&+
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=DEF>=DEG L,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 =SEDEST<=STU= V =UWS<=GSDTD V =SUFFSDTGSXWW V ESWTXSXGTSWX= V FSTWDSGEESUUD V EFS=GFSD=TSDTE V ==S<X=SUU=STWX V ES=WTSTEWSXEE V TESDTDSFG<SUEF V
;-1&6-%& J(&$3 ETS<G=SEX< V > V =FSE=XSWXE V ETSFGGSU<E V TGSXDFSFU= V G=S=XGSXD= V EEXS=UXSUFF V XSF<GS=W= V EUGSEDTSFUU V
!"##"$% '()* ETS<G=SEX< V + , -./0-1/210 , 03/.44/5(0 , TGSXDFSFU= V 4-/-14/16- , EEXS=UXSUFF V XSF<GS=W= V 054/063/.55 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A(0$&8$0 4&-%B3$0,
9(:0&C
=DEF G,:3&1
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;-1&6-%& P(&$3 TQDJS IJQTTRQ=IF U EQRJ=QJTT U RDQDISQD<E U IQITT <QETDQ<JF U RQF<EQJR= U EIQJR=QJ=J U TIQJS<Q<E< U
1arranL (9) 3,087 38,334,236 $ 1,482,833 $ RDQDISQD<E U 3,333 9,130,986 $ 4,691,842 $ EIQJR=QJ=J U TIQJS<Q<E< U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *$&& A6$:1+
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;-1&6-%& J(&$3 E=T<UGT<XG V > V CFTEDCT==G V E=TFX=TW<E V =GTUXXTCCW V GCTE<FTEF= V EEXTE=WT=GC V XTF<DTXGW V EUXT<F=TGX= V
!"##"$% '()* E=T<UGT<XG V + , -./01-/223 , 02/.42/5(0 , =GTUXXTCCW V 3-/0(./0.2 , EEXTE=WT=GC V XTF<DTXGW V 064/(.2/342 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ *$&& A6$:1+
9(:0&B
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4&$&+N-,+ O(&$3 EPDDQPRRE RPFESPDIFPR== T C<CPIIRP<SE T RP<DRP<RQPFIQ T SSDPEI< EPSDDPQ<SP=IQ T RF<P=CSPSRF T CPCF<PICDP<FD T EDPERRPR<SPFQQ T
;-1&6-%& O(&$3 SPDIC =IPSESPDQR T EPQIEP=QI T =<P<<FP=<S T =P=SC <PEQEPFIQ T QPFIRPDR= T E=PICIPRSR T S=PICSPESC T
1arranL (9) 3,082 38,313,047 $ 1,481,348 $ =<P<<FP=<S T 3,332 9,141,684 $ 4,687,073 $ E=PICIPRSR T S=PICSPESC T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;-$0+ A$&6-%B
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;-1&6-%& J(&$3 F=T=EYTYG= W > W D=TXGGTFVY W FUTX<YTGFY W UXTGGUTXGD W G=TVF=T<GU W FF<TXGFTXXE W YTY<<TUU= W FYFT<X<TE== W
!"##"$% '()* F=T=EYTYG= W + , -./011/234 , 25/0(4/124 , UXTGGUTXGD W 1./32./(15 , FF<TXGFTXXE W YTY<<TUU= W 242/(0(/6.. ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ ;-$0+ A$&6-%B
9(:0&C
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.06(33++1
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.06(33++1
*(,+6$&+
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98-3,6+0
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4&$&+O-,+ P(&$3 FQEE=QRRF RQGFSQEKGQRJJ T D<DQKKRQ<SF T RQ<ERQ<R=QGK= T SSEQFK< FQSEEQ=<SQJK= T RG<QJDSQSRG T DQDG<QKDEQ<GE T FEQFRRQR<SQG== T
;-1&6-%& P(&$3 SQD=S J<QRSJQF<D T FQSDKQ<G< T =FQDKDQFGF T JQ=GE <Q=JSQSGD T =QKJRQR=< T F=QDRJQJFF T SSQSSSQ=RD T
1arranL (9) 3,243 39,733,192 $ 1,328,969 $ =FQDKDQFGF T 3,460 9,433,362 $ 4,837,749 $ F=QDRJQJFF T SSQSSSQ=RD T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-%(3+ 9(33-+6
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;-1&6-%& I(&$3 ETS<ECSWD= U > U CFSDCFSDDG U ETSFCDSET= U TGSFFFSEFT U GES<=<S=CT U EE=SGWDS<T< U WSFW<S=VF U E=WSFTTSGEV U
!"##"$% '()* ETS<ECSWD= U + , -./0-./001 , 23/.-0/234 , TGSFFFSEFT U 12/(4(/4-3 , EE=SGWDS<T< U WSFW<S=VF U 245/.33/126 ,
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-%(3+ 9(33-+6
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4&$&+O-,+ P(&$3 EQDDRQSSE SQFE=QDJFQSII T C<CQJJSQ<=E T SQ<DSQ<SRQFJR T ==DQEJ< EQ=DDQR<=QIJR T SF<QIC=Q=SF T CQCF<QJCDQ<FD T EDQESSQS<=QFRR T
;-1&6-%& P(&$3 =QDF= IJQIJ<QJSJ T EQRSFQ=IR T I<QJFFQREC T IQIRE <QEEEQ<S= T RQFSEQJRE T EIQSJIQJEF T =IQF=DQCCJ T
1arranL (9) 3,063 38,389,878 $ 1,476,334 $ I<QJFFQREC T 3,341 9,111,973 $ 4,671,841 $ EIQSJIQJEF T =IQF=DQCCJ T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-33 B+,3+6
9(:0&C
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7+$3&8%$6+ O
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9$6+ 9(1&1
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9(1&1 )(6 2(%$3
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7(1#-&$31
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T+,+6$3 T:0,1
2-"-&+,
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T+,+6$3 T:0,1
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4&$&+J-,+ K(&$3 DUFEFUV<DUVWD X DWYU<DHUEVE X DUWGGUEVHU=YY X FUYV=U=HVUY=D X GUVYEUHFFUWWE X FGUDHGUEDVUEVF X DDU<=DUWWDUVY= X FUDYVUVFYU=FF X VFUEVEUGH<UWFG X
;-1&6-%& K(&$3 FGUF<=UVEY X > X DGUWFVUY<< X FVU=<VUH<W X VYUDEHU=<G X HVUGD=U<EV X FFYUFDFUWEH X =U=EFUWFE X FW<U=DVU=H= X
!"##"$% '()* FGUF<=UVEY X + , -./012/3(( , 12/4(2/5(0 , VYUDEHU=<G X 52/.-4/(62 , FFYUFDFUWEH X =U=EFUWFE X 10(/4-2/454 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-33 B+,3+6
9(:0&C
DEF= G,:3&1
HFIJK LM2
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*(,+6$&+
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DEF= G,:3&1
L+,+6$3 L:0,1
*(,+6$&+
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DEF= G,:3&1
4&$&+ L:0,1
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DEF= G,:3&1
G33 L:0,1
*(,+6$&+
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DEF= 98-3,6+0
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.06(33++1
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L+,+6$3 L:0,1
*(,+6$&+
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DEF= 98-3,6+0
4&$&+ L:0,1
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DEF= 98-3,6+0
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4%+0$6-(
DEF= G,:3&1 N
98-3,6+0
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4&$&+O-,+ P(&$3 FQEERQSSF SQ=FTQEJ=QSII U D<DQJJSQ<TF U SQ<ESQ<SRQ=JR U TTEQFJ< FQTEEQR<TQIJR U S=<QIDTQTS= U DQD=<QJDEQ<=E U FEQFSSQS<TQ=RR U
;-1&6-%& P(&$3 TQF=< I<QFSDQSFT U FQTE=Q=RI U REQ=S<QITJ U IQRE< <QD<SQSJR U RQS=SQFEJ U FRQE=RQJ<D U TRQSRRQDTE U
1arranL (9) 3,169 39,172,713 $ 1,306,643 $ REQ=S<QITJ U 3,409 9,297,784 $ 4,767,108 $ FRQE=RQJ<D U TRQSRRQDTE U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 96$-5 A(3,"$0
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7(1#-&$3 98$6-&B
9$6+ 9(1&1
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9(1&1 )(6 2(%$3
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7(1#-&$31
CDEF>CDE= K,:3&1
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CDEF>CDE= K,:3&1
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K,:3&1 4&$&+
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;-1&6-%& I(&$3 EFSUTWSEED V > V CUSEDFSEE= V EFSDCTSF<< V T<SEC=SXEX V =USE<FS=<F V ECDS<XUSUDU V XS=XDSFUF V EXTSFXXS<EX V
!"##"$% '()* EFSUTWSEED V + , -./012/003 , 02/1-4/2(( , T<SEC=SXEX V 3./0(2/3(2 , ECDS<XUSUDU V XS=XDSFUF V 054/255/(05 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ 96$-5 A(3,"$0
9(:0&B
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4&$&+O-,+ P(&$3 EQDDRQ==E =QFESQDJFQ=II T C<CQJJ=Q<SE T =Q<D=Q<=RQFJR T SSDQEJ< EQSDDQR<SQIJR T =F<QICSQS=F T CQCF<QJCDQ<FD T EDQE==Q=<SQFRR T
;-1&6-%& P(&$3 SQC<I RDQEESQJ=C T EQSRCQ<EJ T REQFSJQ=<D T IQR<E <QSCEQFRF T RQJJEQJJS T ERQRDIQSIE T SFQDFCQICE T
1arranL (9) 3,293 40,113,872 $ 1,342,918 $ REQFSJQ=<D T 3,491 9,321,646 $ 4,881,883 $ ERQRDIQSIE T SFQDFCQICE T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& J(&$3 EFTECUTCUD W > W CFTU=GTGED W EUTXCUTUDV W U=TDEETDEV W GUTDF=T<C= W EEGTVEUTFXD W XTVXGTVC= W EV=T=DET<<E W
!"##"$% '()* EFTECUTCUD W + , -./012/234 , 30/5-0/046 , U=TDEETDEV W 20/4.1/(-1 , EEGTVEUTFXD W XTVXGTVC= W 361/143/((3 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <= > ?+#6+1+0&$&-@+ A-(@$00- 9$#6-53-(0+
9(:0&B
CDEF G,:3&1
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4&$&+N-,+ O(&$3 EPDDQPRRE RPFESPD=FPRII T C<CP==RP<SE T RP<DRP<RQPF=Q T SSDPE=< EPSDDPQ<SPI=Q T RF<PICSPSRF T CPCF<P=CDP<FD T EDPERRPR<SPFQQ T
;-1&6-%& O(&$3 SPEQC I=P<REPDF= T EPQ<=P==R T QDPQF<P<SS T IPI<C <PCQ<P<CC T QPRQCPSF= T EIP<<CPQ<E T SQPQFCPQQF T
1arranL (9) 3,142 38,971,068 $ 1,498,887 $ QDPQF<P<SS T 3,392 9,249,922 $ 4,742,368 $ EIP<<CPQ<E T SQPQFCPQQF T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ 98$63-+ @+6+0
9(:0&A
BCDE=BCDF G+H
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BCDD 9(:0&A
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7(1#-&$3 98$6-&A
9$6+ 9(1&1
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9(1&1 )(6 2(%$3
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7(1#-&$31
BCDE=BCDF K,:3&1
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2-"-&+,
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BCDE=BCDF K,:3&1
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;-1&6-%& I(&$3 DESX<BSFCD V = V BUSTFDSCXD V DESDFBSXDF V T<SUETSXFW V FUS<<ESTFE V DBBSBUDSFWU V XSWTBSTED V DXUSBCUSDTT V
!"##"$% '()* DESX<BSFCD V + , -./012/342 , 25/21-/421 , T<SUETSXFW V 1./((5/015 , DBBSBUDSFWU V XSWTBSTED V 24./-3./200 ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& << = >+#6+1+0&$&-?+ 98$63-+ @+6+0
9(:0&A
BCDE F,:3&1
GDHIJ KL2
.06(33++1
*(,+6$&+
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BCDE F,:3&1
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*(,+6$&+
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BCDE F,:3&1
4&$&+ K:0,1
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4&$&+ K:0,1
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BCDE F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 DPCCQPRRD RPEDSPCIEPRHH T B<BPIIRP<SD T RP<CRP<RQPEIQ T SSCPDI< DPSCCPQ<SPHIQ T RE<PHBSPSRE T BPBE<PIBCP<EC T DCPDRRPR<SPEQQ T
;-1&6-%& O(&$3 SPHQ< QCPSQBPQQB T DPSS<PHBS T QBPDCDPRER T HPSBI <PEBBPI<Q T QP<HHPR<E T DQPSSEPE<C T SEPESIPQSE T
1arranL (9) 3,349 40,342,442 $ 1,339,323 $ QBPDCDPRER T 3,328 9,622,894 $ 4,933,796 $ DQPSSEPE<C T SEPESIPQSE T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ .6-% A(801(0
9(:0&B
C=<D>C=<E F+G
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C=<= H(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
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98$6-&B 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 L
7(1#-&$31
C=<D>C=<E J,:3&1
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C=<D>C=<E J,:3&1
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*(,+6$&+
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C=<D>C=<E
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P:0,1 *(,+6$&+
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P+,+6$3 P:0,1
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4&$&+G-,+ H(&$3 CQ<=<QRSCQRTC U CTVQSCEQ=R= U CQTDDQ=REQWVV U <QVRWQWERQVWC U DQRV=QE<<QTT= U <DQCEDQ=CRQ=R< U CCQSWCQTTCQRVW U <QCVRQR<VQW<< U R<Q=R=QDESQT<D U
;-1&6-%& H(&$3 <TQDVEQSSW U E=WQEEV U R=QW<SQEWE U <WQRSTQW<= U DEQ=<TQREE U EVQ=CWQDDT U <CTQTC=QEWS U EQ=<TQ=RW U <WSQWCCQWEV U
!"# # "$ &'() <TQDVEQSSW U '*+,''- . /*,+01,'+' . 0+,/12,+0* . DEQ=<TQREE U '-,*3+,442 . <CTQTC=QEWS U EQ=<TQ=RW U 0+1,+33,+'- .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ .6-% A(801(0
9(:0&B
C=<D E,:3&1
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4&$&+ J:0,1
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.06(33++1
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C=<D 98-3,6+0
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*(,+6$&+
4%+0$6-(
C=<D E,:3&1 L
98-3,6+0
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*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 <O==POQQ< QOD<RO=HDOQGG S CTCOHHQOTR< S QOT=QOTQPODHP S RR=O<HT <OR==OPTROGHP S QDTOGCRORQD S COCDTOHC=OTD= S <=O<QQOQTRODPP S
;-1&6-%& N(&$3 ROPTC P<ODCDORGQ S <OD=<O=C< S PGOCCQORRH S GOHTQ <=ODCDODTG S ROPPHOPRH S <DO=QRO<R< S RTOG=COQ=T S
ual l as (7) 3,492 41,626,337 $ 1,601,021 $ PGOCCQORRH S 3,897 10,626,693 $ 3,448,438 $ <DO=QRO<R< S RTOG=COQ=T S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=< > ?+#6+1+0&$&-@+ 986-1 A:60+6
9(:0&B
C=<D>C=<E F+G
2(%$3 A$/
?+@+0:+ HI,:3&
./#$01-(0J
C=<< 9(:0&B
!0,-5+0&
7+$3&8%$6+ K
L06+-"M:61+,
N$-3 7+$3&8%$6+
9(1&1
C=<< A(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BO9(:0&B
L06+-"M:61+,
7+$3&8%$6+
./#+0,-&:6+1
C=<= A(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
A(&$3
L06+-"M:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
N:6-1,-%&-(01 K
7(1#-&$31
C=<D>C=<E I,:3&1
P+,+6$3 P:0,1
2-"-&+,
4%+0$6-(
C=<D>C=<E I,:3&1
P+,+6$3 P:0,1
*(,+6$&+
4%+0$6-(
C=<D>C=<E
I,:3&1 4&$&+
P:0,1 *(,+6$&+
4%+0$6-(
C=<D>C=<E I,:3&1
P+,+6$3 P:0,1
.08$0%+, 4%+0$6-(
4&$&+G-,+ A(&$3 CQ<=<QRSCQRTC U CTVQSCEQ=R= U CQTDDQ=REQWVV U <QVRWQWERQVWC U DQRV=QE<<QTT= U <DQCEDQ=CRQ=R< U CCQSWCQTTCQRVW U <QCVRQR<VQW<< U R<Q=R=QDESQT<D U
;-1&6-%& A(&$3 <DQ<ERQD<C U > U CDQDEDQRWR U <RQWE<QE<= U RVQ<DWQ=ER U ERQR=VQDV= U <<EQSR<Q=== U WQTS=QVWR U <TSQRWWQCRD U
!"##"$% '()* <DQ<ERQD<C U + , -./.0./121 , 31/203/034 , RVQ<DWQ=ER U 01/145/.54 , <<EQSR<Q=== U WQTS=QVWR U 36(/122/-1. ,
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=< > ?+#6+1+0&$&-@+ 986-1 A:60+6
9(:0&B
C=<D E,:3&1
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4&$&+ J:0,1
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FC==I JK2
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C=<D 98-3,6+0
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C=<D 98-3,6+0
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*(,+6$&+
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C=<D E,:3&1 L
98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ A(&$3 <N==ONPP< PND<QN=HDNPGG R CSCNHHPNSQ< R PNS=PNSPONDHO R QQ=N<HS <NQ==NOSQNGHO R PDSNGCQNQPD R CNCDSNHC=NSD= R <=N<PPNPSQNDOO R
;-1&6-%& A(&$3 QN<D= GSN<=SNQGP R <NQ=ONC<G R O=ND<GNPQ= R GNO=O SNCHCNPHS R ONPQSNO<S R <ON=OCNC=H R QONDQQNSQH R
1arranL (9) 3,160 39,109,337 $ 1,304,213 $ O=ND<GNPQ= R 3,404 9,282,789 $ 4,739,419 $ <ON=OCNC=H R QONDQQNSQH R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 4&+)$0- 9$6&+6
9(:0&B
>=<C?>=<D E+F
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>=<< 9(:0&B
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;-1&6-%& G(&$3 <TQCVDQR>R U D=WQDCV U R=QW<VQCRD U <WQRSCQVSV U CDQ=<RQRRC U DVQ=>RQ=TW U <>TQT<TQR<W U DQ=<CQDR> U <WSQW<TQR<= U
!"# # "$ &'() <TQCVDQR>R U '*+,'-. / 0*,+1.,-0' / 1+,02-,.2. / CDQ=<RQRRC U '.,*30,*4+ / <>TQT<TQR<W U DQ=<CQDR> U 1+2,+14,01* /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 4&+)$0- 9$6&+6
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>=<C 98-3,6+0
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4%+0$6-(
>=<C D,:3&1 K
98-3,6+0
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4%+0$6-(
4&$&+L-,+ M(&$3 <N==ONPP< PNC<QN=GCNPFF R >S>NGGPNSQ< R PNS=PNSPONCGO R QQ=N<GS <NQ==NOSQNFGO R PCSNF>QNQPC R >N>CSNG>=NSC= R <=N<PPNPSQNCOO R
;-1&6-%& M(&$3 QNOS> O<NC>ONP>S R <NC==NSQ< R OFN>>QNCG= R FNGSC <=NC>CN>F< R QNOOGN>>> R <CN=PONOQF R QSNF==N<FF R
ual l as (7) 3,492 41,624,729 $ 1,600,931 $ OFN>>QNCG= R 3,896 10,626,231 $ 3,448,222 $ <CN=PONOQF R QSNF==N<FF R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+H-,+ I(&$3 DR<=<R>SDR>TD U DTVRSDFR=>= U DRTEER=>FRWVV U <RV>WRWF>RVWD U ER>V=RF<<RTT= U <ERDFER=D>R=>< U DDRSWDRTTDR>VW U <RDV>R><VRW<< U ><R=>=REFSRT<E U
;-1&6-%& I(&$3 <WRS<FRES= U FFDR=<D U >>REETRVFF U <FRS=VRVFE U T<R>TERFT< U VTRDDVR=ET U <>FR<=TRSEF U FRWWDRT=D U <VTRDFVR>DW U
!"# # "$ &'() <WRS<FRES= U ''*+,-* . //+001+2'' . -'+3,2+2'0 . T<R>TERFT< U 21+**2+,01 . <>FR<=TRSEF U FRWWDRT=D U -21+*'2+/*4 .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+L-,+ M(&$3 <N==ONPP< PNE<QN=GENP>> R DSDNGGPNSQ< R PNS=PNSPONEGO R QQ=N<GS <NQ==NOSQN>GO R PESN>DQNQPE R DNDESNGD=NSE= R <=N<PPNPSQNEOO R
;-1&6-%& M(&$3 QNSSS OQNOEGNQ>G R <NPOGNPS= R OPND<PN>DG R ONDQE <<NE=PNQ=O R QNSQ<N>>O R <PNQQGNG>G R EONPPEN<EQ R
ual l as (7) 3,999 43,468,338 $ 1,748,790 $ OPND<PN>DG R 4,236 11,607,304 $ 3,931,334 $ <PNQQGNG>G R EONPPEN<EQ R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 104 - kepresentat|ve koberto k. A|onzo
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 16,606,8S2 5 7S7,836 5 32,831,74S 5 17,S80,032 5 S0,411,776 5 83,663,090 5 134,S88,412 5 7,S21,804 5 181,876,2S2 5
!"# # "$ &'() 16,606,8S2 5 '*'+,-. / -0+,-1+'2* / 1'+*,3+3-0 / S0,411,776 5 ,-+..-+343 / 134,S88,412 5 7,S21,804 5 1,1+,'.+0*0 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 104 - kepresentat|ve koberto k. A|onzo
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| S,889 44,633,646 5 1,716,679 5 46,3S0,32S 5 4,178 11,394,367 5 S,842,0S6 5 17,236,423 5 63,S86,748 5
ual l as (7) 3,889 44,633,646 $ 1,716,679 $ 46,3S0,32S 5 4,178 11,394,367 $ 3,842,036 $ 17,236,423 5 63,S86,748 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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!"# # "$ &'() <XSWWUSW=U V ''*+',- . //+/-0+012 . 0'+3'-+1'0 . ><SEG=SGET V 31+*33+1-/ . <TXSWW<SX<E V GSXFUSUX> V 03,+-'1+0'0 .
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4%+0$6-(
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98-3,6+0
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*(,+6$&+
4%+0$6-(
4&$&+C-,+ O(&$3 <P==QPRR< RPF<>P=JFPRII S ETEPJJRPT>< S RPT=RPTRQPFJQ S >>=P<JT <P>==PQT>PIJQ S RFTPIE>P>RF S EPEFTPJE=PTF= S <=P<RRPRT>PFQQ S
;-1&6-%& O(&$3 >PTT= Q>PITQP<Q< S <PRQ>PTET S QRP<Q=P=R= S QPEQT <<P>JJP><< S >PTQ<P>TR S <RP>I=P<=J S FQPFR=P<RJ S
ual l as (7) 3,990 43,394,141 $ 1,743,929 $ QRP<Q=P=R= S 4,249 11,388,311 $ 3,941,397 $ <RP>I=P<=J S FQPFR=P<RJ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& J(&$3 <FSTXVS=E< W <S<UGSEEV W ESX>>SUT< W ? W ESX>>SUT< W V<S>GESTXX W XTS<EVS<ET W FS>FVS>VE W <<ESTT<SEVU W
!"#$%# '()*+ <FSTXVS=E< W ,-,./-((0 1 (-233-.4, 1 5 1 ESX>>SUT< W 0,-3/(-422 1 XTS<EVS<ET W FS>FVS>VE W ,,(-44,-(0. 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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*(,+6$&+
4%+0$6-(
4&$&+L-,+ M(&$3 <N==ONPP< PN><QN=I>NPHH R ESENIIPNSQ< R PNS=PNSPON>IO R QQ=N<IS <NQ==NOSQNHIO R P>SNHEQNQP> R ENE>SNIE=NS>= R <=N<PPNPSQN>OO R
;-1&6-%& M(&$3 HN>HP EPNQ>>NIO< R <N=>=NE>H R EIN>EPN<=O R <NSIP QNO<IN=OQ R ENPPPNS=S R IN<SQNSQO R H>NIEHN=QI R
uenLon (24) 3,637 27,366,841 $ 1,060,263 $ EIN>EPN<=O R 1,987 3,418,043 $ 2,777,909 $ IN<SQNSQO R H>NIEHN=QI R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B+00+&8 48++&1
9(:0&C
D=<E?D=<> F+G
2(%$3 H$/
@+A+0:+ IJ,:3&
./#$01-(0K
D=<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ L
M06+-"N:61+,
O$-3 7+$3&8%$6+
9(1&1
D=<< H(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CP9(:0&C
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
D=<= H(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
H(&$3
M06+-"N:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
D=<E?D=<> J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
D=<E?D=<> J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
D=<E?D=<>
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
D=<E?D=<> J,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+G-,+ H(&$3 DR<=<RSTDRSUD V DUWRTD>R=S= V DRUEER=S>RXWW V <RWSXRX>SRWXD V ERSW=R><<RUU= V <ERD>ER=DSR=S< V DDRTXDRUUDRSWX V <RDWSRS<WRX<< V S<R=S=RE>TRU<E V
;-1&6-%& H(&$3 <XRU<TR<TX V >USRWSX V SDRXUWREU= V <>REW>RDE= V U=R<EURXT= V WSRDD<RETE V <SSRW>WR=<W V >REWDR<=D V <W=RT<XRDX< V
!"# # "$ &'() <XRU<TR<TX V '*+,-+. / +0,.*-,1*2 / 3',1-',012 / U=R<EURXT= V -+,003,141 / <SSRW>WR=<W V >REWDR<=D V 3-2,43.,0.3 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B+00+&8 48++&1
9(:0&C
D=<E F,:3&1
G<HIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
GD==J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <P==QP>>< >PE<RP=IEP>HH S DTDPII>PTR< S >PT=>PT>QPEIQ S RR=P<IT <PR==PQTRPHIQ S >ETPHDRPR>E S DPDETPID=PTE= S <=P<>>P>TRPEQQ S
;-1&6-%& O(&$3 RPIRI QQPHTIP=RI S <P>=>PE<I S QEP<=RPE>R S QP<RE <<PHHQPDDR S RPI<<PDD= S <>P<QRPQQR S EHPDR<P<D= S
ual l as (7) 3,838 44,398,038 $ 1,707,618 $ QEP<=RPE>R S 4,136 11,334,223 $ 3,811,220 $ <>P<QRPQQR S EHPDR<P<D= S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ ;$0 B6$0%8
9(:0&C
D=<E?D=<F G+H
2(%$3 I$/
@+A+0:+ JK,:3&
./#$01-(0L
D=<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
D=<< I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
D=<= I(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
D=<E?D=<F K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
D=<E?D=<F K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
D=<E?D=<F
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
D=<E?D=<F K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 DS<=<STUDSTVD W DV>SUDFS=T= W DSVEES=TFSX>> W <S>TXSXFTS>XD W EST>=SF<<SVV= W <ESDFES=DTS=T< W DDSUXDSVVDST>X W <SD>TST<>SX<< W T<S=T=SEFUSV<E W
;-1&6-%& I(&$3 <VSX>>S>FT W F<VSUEV W T<S=<XSU=< W <XSX=>SDV> W EFSXDVS<VU W FUS=T>SETX W <DFS<E>SFVE W FS<=XS=D= W <F<S>DDSXV> W
!"# # "$ &'() <VSX>>S>FT W '*+,-.+ / 0*,1*2,-1* / *2,213,4+3 / EFSXDVS<VU W '-,103,.02 / <DFS<E>SFVE W FS<=XS=D= W *'*,344,2+3 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ ;$0 B6$0%8
9(:0&C
D=<E F,:3&1
G<H>I JK2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
F33 J:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
GD==I JK2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
F33 J:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1 L
98-3,6+0
F33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 <O==POQQ< QOE<RO=>EOQHH S DTDO>>QOTR< S QOT=QOTQPOE>P S RR=O<>T <OR==OPTROH>P S QETOHDRORQE S DODETO>D=OTE= S <=O<QQOQTROEPP S
;-1&6-%& N(&$3 ROREP PDO<EEOPDQ S <OED<OQ>E S PHOQ>>OD<H S HOTPQ <=OQEPOR<T S ROR<TO<DP S <EOD>HOEPH S E=O=Q<O>RE S
ual l as (7) 3,364 42,166,427 $ 1,621,786 $ PHOQ>>OD<H S 3,947 10,764,319 $ 3,319,124 $ <EOD>HOEPH S E=O=Q<O>RE S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 7+3+0 B-,,-051
9(:0&C
D=<E?D=<F G+H
2(%$3 I$/
@+A+0:+ JK,:3&
./#$01-(0L
D=<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
D=<< I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
D=<= I(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
D=<E?D=<F K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
D=<E?D=<F K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
D=<E?D=<F
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
D=<E?D=<F K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 DS<=<ST>DSTUD V DUWS>DFS=T= V DSUEES=TFSXWW V <SWTXSXFTSWXD V ESTW=SF<<SUU= V <ESDFES=DTS=T< V DDS>XDSUUDSTWX V <SDWTST<WSX<< V T<S=T=SEF>SU<E V
;-1&6-%& I(&$3 <XSFE=SXE< V FXTS>ED V TTS=>XSDEF V <FSFD<SXXD V U=SW<FS>=> V WESTTFS<=U V <TUSXFDSX>F V FSUWDSE=D V <WTSTE<SU=D V
!"# # "$ &'() <XSFE=SXE< V '*+,-./ 0 ++,1-*,/.' 0 2','/2,**/ 0 U=SW<FS>=> V 3.,++',214 0 <TUSXFDSX>F V FSUWDSE=D V 23+,+.2,41/ 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 7+3+0 B-,,-051
9(:0&C
D=<E F,:3&1
G<HIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
GD==J KL2
.06(33++1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
D=<E 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
D=<E F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <P==QPRR< RPE<SP=IEPRHH T D>DPIIRP>S< T RP>=RP>RQPEIQ T SS=P<I> <PS==PQ>SPHIQ T RE>PHDSPSRE T DPDE>PID=P>E= T <=P<RRPR>SPEQQ T
;-1&6-%& O(&$3 SP>HR QQP>>HPDDI T <PRH=PS=> T QEPRDHPRHR T QPD<D <<PQIEP<EQ T SPII>P<D< T <RPHRSPDIS T EQP=>>P=DD T
ual l as (7) 3,937 44,993,228 $ 1,730,309 $ QEPRDHPRHR T 4,212 11,486,164 $ 3,889,121 $ <RPHRSPDIS T EQP=>>P=DD T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A(0- ?(1+
9(:0&B
C=<D>C=<E F+G
2(%$3 A$/
?+@+0:+ HI,:3&
./#$01-(0J
C=<< 9(:0&B
!0,-5+0&
7+$3&8%$6+ K
L06+-"M:61+,
N$-3 7+$3&8%$6+
9(1&1
C=<< A(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BO9(:0&B
L06+-"M:61+,
7+$3&8%$6+
./#+0,-&:6+1
C=<= A(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
A(&$3
L06+-"M:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
N:6-1,-%&-(01 K
7(1#-&$31
C=<D>C=<E I,:3&1
P+,+6$3 P:0,1
2-"-&+,
4%+0$6-(
C=<D>C=<E I,:3&1
P+,+6$3 P:0,1
*(,+6$&+
4%+0$6-(
C=<D>C=<E
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4%+0$6-(
C=<D>C=<E I,:3&1
P+,+6$3 P:0,1
.08$0%+, 4%+0$6-(
4&$&+G-,+ A(&$3 CQ<=<QRSCQRTC U CTVQSCEQ=R= U CQTDDQ=REQWVV U <QVRWQWERQVWC U DQRV=QE<<QTT= U <DQCEDQ=CRQ=R< U CCQSWCQTTCQRVW U <QCVRQR<VQW<< U R<Q=R=QDESQT<D U
;-1&6-%& A(&$3 <WQ<=RQT=W U ERDQVWE U R<QVRWQWR= U <EQ=DEQ<VS U DVQVVRQVC= U V<Q<CEQR=C U <R=QT=SQ<=C U EQCSRQVCC U <EWQRWRQWE= U
!"# # "$ &'() <WQ<=RQT=W U '*+,-.' / *0,-*.,.*1 / 0',1+',0-2 / DVQVVRQVC= U -0,03',*13 / <R=QT=SQ<=C U EQCSRQVCC U 0'.,*.*,.'1 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A(0- ?(1+
9(:0&B
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C=<D 98-3,6+0
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*(,+6$&+
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C=<D E,:3&1 L
98-3,6+0
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*(,+6$&+
4%+0$6-(
4&$&+M-,+ A(&$3 <N==ONPP< PND<QN=HDNPGG R CSCNHHPNSQ< R PNS=PNSPONDHO R QQ=N<HS <NQ==NOSQNGHO R PDSNGCQNQPD R CNCDSNHC=NSD= R <=N<PPNPSQNDOO R
;-1&6-%& A(&$3 QNP<< OGNCH=NHC< R <NDDONDOP R OONSOQNODH R ON=Q< <<N=OSN==S R QNDDONSHD R <DNP<GNSSQ R D<NDQSNODO R
ual l as (7) 3,711 43,280,821 $ 1,664,647 $ OONSOQNODH R 4,031 11,049,009 $ 3,664,986 $ <DNP<GNSSQ R D<NDQSNODO R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<< = >+#6+1+0&$&-?+ @?(00+ ;$?-1
9(:0&A
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>+?+0:+ IJ,:3&
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9$6+ 9(1&1
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9(1&1 )(6 2(%$3
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4&$&+G-,+ H(&$3 BR<C<RSTBRSUB V BUWRTBERCSC V BRUDDRCSERXWW V <RWSXRXESRWXB V DRSWCRE<<RUUC V <DRBEDRCBSRCS< V BBRTXBRUUBRSWX V <RBWSRS<WRX<< V S<RCSCRDETRU<D V
;-1&6-%& H(&$3 <XRCDWRT<D V ESBRSEU V S<REBWREC< V <XRTWTRSTW V DWRE<WRCTT V WCRWUBRBES V <SCRCXXRXXD V ERBXTRCTU V <EUREXUREW< V
!"# # "$ &'() <XRCDWRT<D V '*+,*'- . */,'+0,'1/ . /2,303,*30 . DWRE<WRCTT V 01,0-+,+'* . <SCRCXXRXXD V ERBXTRCTU V /'-,'2-,'0/ .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<< = >+#6+1+0&$&-?+ @?(00+ ;$?-1
9(:0&A
BC<D E,:3&1
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.06(33++1
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.06(33++1
*(,+6$&+
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BC<D 98-3,6+0
4&$&+ J:0,1
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BC<D 98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
BC<D E,:3&1 L
98-3,6+0
E33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 <OCCPOQQ< QOD<ROCHDOQGG S BTBOHHQOTR< S QOTCQOTQPODHP S RRCO<HT <ORCCOPTROGHP S QDTOGBRORQD S BOBDTOHBCOTDC S <CO<QQOQTRODPP S
;-1&6-%& N(&$3 RODT< PGO<GPOCTR S <ODRTOCCP S PPOQTGOCTT S POCGH <<OC<<ORRB S RODPROQH< S <DODRQOGGG S D<OPRCOPGG S
ual l as (7) 3,691 43,134,093 $ 1,639,004 $ PPOQTGOCTT S 4,038 11,011,332 $ 3,643,781 $ <DODRQOGGG S D<OPRCOPGG S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A05-+ 98+0 B:&&(0
9(:0&C
=D<E>=D<F G+H
2(%$3 I$/
?+@+0:+ JA,:3&
./#$01-(0K
=D<< 9(:0&C
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7+$3&8%$6+ L
M06+-"N:61+,
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=D<D I(&$3
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9(1&1 )(6 2(%$3
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7(1#-&$31
=D<E>=D<F A,:3&1
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=D<E>=D<F A,:3&1
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=D<E>=D<F
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4&$&+H-,+ I(&$3 =R<D<RST=RSU= V =UWRT=FRDSD V =RUEERDSFRXWW V <RWSXRXFSRWX= V ERSWDRF<<RUUD V <ER=FERD=SRDS< V ==RTX=RUU=RSWX V <R=WSRS<WRX<< V S<RDSDREFTRU<E V
;-1&6-%& I(&$3 <XRDUURWSE V FS=RXT< V S<RFE=RSW= V <XRTTXRF=S V EWRFSTR<DX V WDRWWFR<SX V <SDR<==RFEW V FR=F=R==T V <FURWE<RUFD V
!"# # "$ &'() <XRDUURWSE V '*+,-./ 0 */,'1+,*2+ 0 /-,..-,'+* 0 EWRFSTR<DX V 23,22',/*- 0 <SDR<==RFEW V FR=F=R==T V /'4,21/,4'3 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A05-+ 98+0 B:&&(0
9(:0&C
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*(,+6$&+
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=D<E A,:3&1 L
98-3,6+0
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4&$&+M-,+ N(&$3 <ODDPOQQ< QOE<RODHEOQGG S =T=OHHQOTR< S QOTDQOTQPOEHP S RRDO<HT <ORDDOPTROGHP S QETOG=RORQE S =O=ETOH=DOTED S <DO<QQOQTROEPP S
;-1&6-%& N(&$3 ROETP PGO<R=OETR S <OERTOQ<T S PPOH<=OP<P S PODGT <<OD<EOGDD S ROEPHO=<E S <EOEEPOR<E S E<OPQEOT=T S
ual l as (7) 3,694 43,132,693 $ 1,639,719 $ PPOH<=OP<P S 4,039 11,016,300 $ 3,648,216 $ <EOEEPOR<E S E<OPQEOT=T S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














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;-1&6-%& J(&$3 <YTFGFTGUD W GV<TX<E W =DTVGETYY= W <GTFFETD== W VETE<ETXUY W XDTUUGTGU< W <==TV<XT<FX W GTFY<TUXU W <XETFDUTUFU W
!"# # "$ &'() <YTFGFTGUD W '*+,-+. / 01,*'.,220 / +',33.,100 / VETE<ETXUY W -1,44','4+ / <==TV<XT<FX W GTFY<TUXU W +-.,314,434 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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.06(33++1
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4&$&+ K:0,1
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DE<F 98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
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98-3,6+0
G33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PEEQPRR< RPF<SPEIFPR== T DUDPIIRPUS< T RPUERPURQPFIQ T SSEP<IU <PSEEPQUSP=IQ T RFUP=DSPSRF T DPDFUPIDEPUFE T <EP<RRPRUSPFQQ T
;-1&6-%& O(&$3 SPIQD QQPDRIPR<= T <PRE=PEDR T QSPUI<PRQ< T QP<QS <<P=E=PRSI T SPRUSPSUU T <RPEUUP=SR T F=PEI<PEUI T
ual l as (7) 3,842 44,278,713 $ 1,703,027 $ QSPUI<PRQ< T 4,143 11,303,738 $ 3,793,399 $ <RPEUUP=SR T F=PEI<PEUI T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A$1(0 B-33$3C$
9(:0&D
EF<=>EF<G H+I
2(%$3 J$/
?+@+0:+ KL,:3&
./#$01-(0M
EF<< 9(:0&D
!0,-5+0&
7+$3&8%$6+ N
O06+-"C:61+,
A$-3 7+$3&8%$6+
9(1&1
EF<< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DP9(:0&D
O06+-"C:61+,
7+$3&8%$6+
./#+0,-&:6+1
EF<F J(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
J(&$3
O06+-"C:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
A:6-1,-%&-(01 N
7(1#-&$31
EF<=>EF<G L,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
EF<=>EF<G L,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
EF<=>EF<G
L,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
EF<=>EF<G L,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 ER<F<RSTERSUE V EUWRTEGRFSF V ERU==RFSGRXWW V <RWSXRXGSRWXE V =RSWFRG<<RUUF V <=REG=RFESRFS< V EERTXERUUERSWX V <REWSRS<WRX<< V S<RFSFR=GTRU<= V
;-1&6-%& J(&$3 <XRUXSRE<X V GUURW=U V SERG=UR=GG V <GRUSSRWST V UFREGTRS<X V WSR==SREX< V <S=RES=RGGS V GRUFERF=F V <W<RSTWRSX< V
!"# # "$ &'() <XRUXSRE<X V '**+,-* . /0+'-*+-'' . 1'+*//+,/2 . UFREGTRS<X V ,/+--/+031 . <S=RES=RGGS V GRUFERF=F V 1,1+/2,+/31 .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A$1(0 B-33$3C$
9(:0&D
EF<G H,:3&1
I<JKL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1
H33 M:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
IEFFL MN2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
M+,+6$3 M:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
4&$&+ M:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
H33 M:0,1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1 O
98-3,6+0
H33 M:0,1
*(,+6$&+
4%+0$6-(
4&$&+P-,+ Q(&$3 <RFF=RSS< SRG<TRFKGRSJJ U EVERKKSRVT< U SRVFSRVS=RGK= U TTFR<KV <RTFFR=VTRJK= U SGVRJETRTSG U EREGVRKEFRVGF U <FR<SSRSVTRG== U
;-1&6-%& Q(&$3 TRKS= ==RT<GRJGK U <RS<ER<GK U =GREEKRTJG U =R<GS <<RJG=R=EK U TRKEGRSFG U <SR<V<R<JJ U GJR=<VRGSF U
ual l as (7) 3,874 44,316,368 $ 1,712,168 $ =GREEKRTJG U 4,167 11,364,428 $ 3,826,706 $ <SR<V<R<JJ U GJR=<VRGSF U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A+00+&& ?$&3-))
9(:0&B
CD<E>CD<F G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
CD<< 9(:0&B
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
CD<< I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BQ9(:0&B
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
CD<D I(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
CD<E>CD<F K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
CD<E>CD<F K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
CD<E>CD<F
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
CD<E>CD<F K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 CS<D<STUCST=C V C=WSUCFSDTD V CS=EESDTFSXWW V <SWTXSXFTSWXC V ESTWDSF<<S==D V <ESCFESDCTSDT< V CCSUXCS==CSTWX V <SCWTST<WSX<< V T<SDTDSEFUS=<E V
;-1&6-%& I(&$3 <XSDC=STXX V FT<STD< V T<SXWCS<EF V <XSUXESEFD V EWSXEXSX<F V WDSFTTSXET V <CUSWF=SWCT V FSC=WSECU V <F=S=DFSWWW V
!"# # "$ &'() <XSDC=STXX V '*+,*-+ . *+,/01,+2' . +/,3/2,2'- . EWSXEXSX<F V 0-,'**,/2* . <CUSWF=SWCT V FSC=WSECU V +'4,4-',000 .
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A+00+&& ?$&3-))
9(:0&B
CD<E F,:3&1
G<HIJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CD<E F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CD<E F,:3&1
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CD<E F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
CD<E 98-3,6+0
GCDDJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
CD<E 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
CD<E 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
CD<E 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
CD<E F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PDDQPRR< RPE<=PDIEPRHH S CTCPIIRPT=< S RPTDRPTRQPEIQ S ==DP<IT <P=DDPQT=PHIQ S RETPHC=P=RE S CPCETPICDPTED S <DP<RRPRT=PEQQ S
;-1&6-%& O(&$3 =PEIH QHPDRDPIDR S <PE=EP=ET S QQPRCRPHRE S QPDHC <DPTT=PHT= S =PEHRPQTR S <EPEHCPITH S E<PHEDPCET S
ual l as (7) 3,683 43,070,807 $ 1,636,369 $ QQPRCRPHRE S 4,032 10,993,393 $ 3,637,497 $ <EPEHCPITH S E<PHEDPCET S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A6+B *$6&-0+C D-1%8+6
9(:0&B
EF<G>EF<H I+J
2(%$3 A$/
?+@+0:+ KL,:3&
./#$01-(0M
EF<< 9(:0&B
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
Q$-3 7+$3&8%$6+
9(1&1
EF<< A(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&BR9(:0&B
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
EF<F A(&$3
7(1#-&$3 98$6-&B
9$6+ 9(1&1
A(&$3
O06+-"P:61+,
98$6-&B 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
EF<G>EF<H L,:3&1
D+,+6$3 D:0,1
2-"-&+,
4%+0$6-(
EF<G>EF<H L,:3&1
D+,+6$3 D:0,1
*(,+6$&+
4%+0$6-(
EF<G>EF<H
L,:3&1 4&$&+
D:0,1 *(,+6$&+
4%+0$6-(
EF<G>EF<H L,:3&1
D+,+6$3 D:0,1
.08$0%+, 4%+0$6-(
4&$&+J-,+ A(&$3 ES<F<STUESTVE W EVXSUEHSFTF W ESVGGSFTHS=XX W <SXT=S=HTSX=E W GSTXFSH<<SVVF W <GSEHGSFETSFT< W EESU=ESVVESTX= W <SEXTST<XS=<< W T<SFTFSGHUSV<G W
;-1&6-%& A(&$3 <TSFGES<XX W GVSFVF W EXS=FTS=FF W <TS=<ESEXV W GESE<VSXXG W <FHSVEHS=V< W <HESUHUSE<= W US==HST=X W ETTSHVVSHET W
!"#$% '()*+ <TSFGES<XX W ,-.)-) / 01.2)3.2)) / (3.2(0.01- / GESE<VSXXG W ()4.-04.2-( / <HESUHUSE<= W US==HST=X W 033.4--.403 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A6+B *$6&-0+C D-1%8+6
9(:0&B
EF<= G,:3&1
H<IJK DL2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<= G,:3&1
D+,+6$3 D:0,1
*(,+6$&+
4%+0$6-(
EF<= G,:3&1
4&$&+ D:0,1
*(,+6$&+
4%+0$6-(
EF<= G,:3&1
G33 D:0,1
*(,+6$&+
4%+0$6-(
EF<= 98-3,6+0
HEFFK DL2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<= 98-3,6+0
D+,+6$3 D:0,1
*(,+6$&+
4%+0$6-(
EF<= 98-3,6+0
4&$&+ D:0,1
*(,+6$&+
4%+0$6-(
EF<= 98-3,6+0
G33 D:0,1
*(,+6$&+
4%+0$6-(
EF<= G,:3&1 M
98-3,6+0
G33 D:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ A(&$3 <OFFPOQQ< QO=<ROFJ=OQII S ETEOJJQOTR< S QOTFQOTQPO=JP S RRFO<JT <ORFFOPTROIJP S Q=TOIERORQ= S EOE=TOJEFOT=F S <FO<QQOQTRO=PP S
;-1&6-%& A(&$3 QOR=T RQOI=ROE<P S EOEF=OIRP S RTORQ<OR=T S IOJEQ <FOPIQOE<F S ROIR<OIFJ S <ROQJJOR<J S QROI=FOFJQ S
8exar (10) 7,369 37,363,214 $ 2,206,334 $ RTORQ<OR=T S 3,827 10,437,210 $ 3,331,308 $ <ROQJJOR<J S QROI=FOFJQ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A8-3-# 9(6&+B
9(:0&C
DE<F>DE<= G+H
2(%$3 I$/
?+@+0:+ JK,:3&
./#$01-(0L
DE<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
DE<< I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
DE<E I(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
DE<F>DE<= K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
DE<F>DE<= K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
DE<F>DE<=
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
DE<F>DE<= K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 DS<E<STUDSTVD W DVXSUD=SETE W DSVFFSET=SYXX W <SXTYSY=TSXYD W FSTXES=<<SVVE W <FSD=FSEDTSET< W DDSUYDSVVDSTXY W <SDXTST<XSY<< W T<SETESF=USV<F W
;-1&6-%& I(&$3 <DSXT<SF<V W FFSTDD W DXS<F<STTU W <TSTUDSDUX W F<SVTTSYT= W <EVS=XUSUEV W <=ES<XTS=<T W USV<<S<TV W DDUSU=XSE<V W
!"#$% '()*+ <DSXT<SF<V W ,,-.// 0 /1-(,(-..2 0 (.-.2/-/21 0 F<SVTTSYT= W ()3-412-2)3 0 <=ES<XTS=<T W USV<<S<TV W //2-241-)(3 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+N-,+ O(&$3 <PEEQP==< =PF<RPEJFP=II S DTDPJJ=PTR< S =PTE=PT=QPFJQ S RREP<JT <PREEPQTRPIJQ S =FTPIDRPR=F S DPDFTPJDEPTFE S <EP<==P=TRPFQQ S
;-1&6-%& O(&$3 =PQQ= RFPQIJP<IT S DP<=EPFTJ S RJPFEJPJI= S IP=FR <EPDFJPRIR S RPDFQPJDF S <RPRIIPIF< S =QP<QDP<TJ S
8exar (10) 7,447 36,438,139 $ 2,170,698 $ RJPFEJPJI= S 3,763 10,268,333 $ 3,264,826 $ <RPRIIPIF< S =QP<QDP<TJ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A(+ B$6-$1
9(:0&C
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9$6+ 9(1&1
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9(1&1 )(6 2(%$3
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7(1#-&$31
DE<F>DE<G L,:3&1
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4&$&+I-,+ J(&$3 DR<E<RSTDRSUD V DU=RTDGRESE V DRUFFRESGRW== V <R=SWRWGSR=WD V FRS=ERG<<RUUE V <FRDGFREDSRES< V DDRTWDRUUDRS=W V <RD=SRS<=RW<< V S<RESERFGTRU<F V
;-1&6-%& J(&$3 <DRUEGRW=W V FSRDEF V DGRFS<RSUE V <SREUFRF<= V FERF=URGW= V <ESR<DER=== V <WUR=TEREG= V TRDG<R<GF V DDFR<GUR=EU V
!"#$% '()*+ <DRUEGRW=W V ,-./), 0 /1.,-(.-2) 0 (-.)2,.,(3 0 FERF=URGW= V ()-.(/).333 0 <WUR=TEREG= V TRDG<R<GF V //,.(12.3)2 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ A(+ B$6-$1
9(:0&C
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.06(33++1
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4&$&+ B:0,1
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G33 B:0,1
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DE<F G,:3&1 L
98-3,6+0
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4%+0$6-(
4&$&+M-,+ N(&$3 <OEEPOQQ< QOF<ROE=FOQII S DTDO==QOTR< S QOTEQOTQPOF=P S RREO<=T <OREEOPTROI=P S QFTOIDRORQF S DODFTO=DEOTFE S <EO<QQOQTROFPP S
;-1&6-%& N(&$3 QODRT RROE<PODI= S DO<<ROTID S RQO<IEO<Q< S IOFQE <EOEETOPFF S RO<I<OTTQ S <RO<P<OPFP S QDODQ<OFIP S
8exar (10) 7,239 33,014,238 $ 2,113,932 $ RQO<IEO<Q< S 3,670 10,009,466 $ 3,131,997 $ <RO<P<OPFP S QDODQ<OFIP S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














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7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ ?(3$0, A:&-+66+B
9(:0&C
DE<F>DE<G H+I
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98$6-&C 9$6+
9(1&1 )(6 2(%$3
Q:6-1,-%&-(01 N
7(1#-&$31
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DE<F>DE<G L,:3&1
S+,+6$3 S:0,1
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DE<F>DE<G
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4&$&+I-,+ J(&$3 DT<E<TU=DTUVD W DVXT=DGTEUE W DTVFFTEUGTYXX W <TXUYTYGUTXYD W FTUXETG<<TVVE W <FTDGFTEDUTEU< W DDT=YDTVVDTUXY W <TDXUTU<XTY<< W U<TEUETFG=TV<F W
;-1&6-%& J(&$3 <DT<YXTXDE W FDTEUU W DYTYXXT<YU W <DTGEETGFE W U=TUXXT=EU W <EETUDGTEGF W <Y<TU=VTYXU W =TE<=T==F W D<XT<EDTD=X W
!"#$% '()* <DT<YXTXDE W +,-.// 0 ,1-122-31/ 0 3,-4..-4+. 0 U=TUXXT=EU W 3..-/,4-.4+ 0 <Y<TU=VTYXU W =TE<=T==F W ,32-3.,-,(2 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <<= > ?+#6+1+0&$&-@+ ?(3$0, A:&-+66+B
9(:0&C
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.06(33++1
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.06(33++1
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4%+0$6-(
DE<F G,:3&1 N
98-3,6+0
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*(,+6$&+
4%+0$6-(
4&$&+O-,+ P(&$3 <QEERQSS< SQF<TQEJFQSII U D=DQJJSQ=T< U SQ=ESQ=SRQFJR U TTEQ<J= <QTEEQR=TQIJR U SF=QIDTQTSF U DQDF=QJDEQ=FE U <EQ<SSQS=TQFRR U
;-1&6-%& P(&$3 SQEFD TIQTDIQST= U DQETJQFEF U TTQTJDQIFT U IQTS< =QSIJQDJR U RQ==DQ=TJ U <RQSI<QDRD U SEQI<IQFES U
8exar (9) 7,062 33,323,739 $ 2,038,606 $ TTQTJDQIFT U 3,371 9,738,284 $ 4,992,938 $ <RQSI<QDRD U SEQI<IQFES U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














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!"#$% '()*+ <RQR=<Q=WV U ,-.)(, / 01.0(2.--2 / (3.1)3.2-3 / DRQ<<SQ==V U ()1.404.2,1 / <EWQWV>QWW< U SQVEDQ=R= U 034.525.-52 /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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98-3,6+0
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4&$&+M-,+ N(&$3 <O>>POQQ< QOD<RO>HDOQGG S =T=OHHQOTR< S QOT>QOTQPODHP S RR>O<HT <OR>>OPTROGHP S QDTOG=RORQD S =O=DTOH=>OTD> S <>O<QQOQTRODPP S
;-1&6-%& N(&$3 QOQG< RHORT=OQ=Q S =O=RGORDD S D>OHPDO=TG S GOT>T <>ODD>ORPH S ROPDROH<D S <DO<=DOGDP S QDOTQ=ODRQ S
8exar (10) 7,731 38,392,727 $ 2,233,366 $ D>OHPDO=TG S 3,909 10,660,348 $ 3,463,816 $ <DO<=DOGDP S QDOTQ=ODRQ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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!"#$% '()*+ <RQRC<Q<<< U ,-./,- 0 1/.(2(.,-3 0 (4.331.-1- 0 DRQCTRQSVR U ()/.551.454 0 <EWQD<RQR<E U SQVTSQ=S< U 143.4/5.,)) 0
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ N(&$3 <OCCPOQQ< QOD<ROCHDOQGG S =T=OHHQOTR< S QOTCQOTQPODHP S RRCO<HT <ORCCOPTROGHP S QDTOG=RORQD S =O=DTOH=COTDC S <CO<QQOQTRODPP S
;-1&6-%& N(&$3 QOQ<T RHORCPOCDQ S =O=RCO<RD S DCOQRPO==P S GOTCG <CODPPOP<Q S ROPRQORPD S <DO<C<OTDG S QDOHRDO<HD S
8exar (10) 7,719 38,304,067 $ 2,230,136 $ DCOQRPO==P S 3,903 10,644,417 $ 3,437,346 $ <DO<C<OTDG S QDOHRDO<HD S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL from
reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed cosLs
due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL full
year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng Lhese
daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& G(&$3 <RQR=TQ==R U CWQB=V U =SQ==CQRCB U <RQSBDQWS< U CRQ<R=QBR< U <BSQVW<Q<WB U <DWQDRRQ<=B U SQVDDQ<WC U =RVQV=VQTWD U
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!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ 2A3+ 2$61(0
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4&$&+L-,+ M(&$3 <NBBONPP< PNC<QNBGCNPFF R =S=NGGPNSQ< R PNSBPNSPONCGO R QQBN<GS <NQBBNOSQNFGO R PCSNF=QNQPC R =N=CSNG=BNSCB R <BN<PPNPSQNCOO R
;-1&6-%& M(&$3 PNPFF QGNC<BN<=O R =N=QON=FC R CBNGCONFQS R FNS<B <BNCCFNP<F R QNOCPNOFS R <CN<F<N<Q= R PCNSSQNQ<= R
8exar (10) 7,733 38,610,124 $ 2,234,236 $ CBNGCONFQS R 3,910 10,663,713 $ 3,467,439 $ <CN<F<N<Q= R PCNSSQNQ<= R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














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9(:0&D
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@+A+0:+ KL,:3&
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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9(:0&D
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;-1&6-%& O(&$3 RPRSS SIPRRQPEFE T =P=FEPSQ< T F<PE>QPFE< T >PU=< <EPFU>PSQE T SPQI=PR>= T <FP<RFP=R= T RRP=<EPIR> T
8exar (10) 7,733 38,774,060 $ 2,260,341 $ F<PE>QPFE< T 3,921 10,693,340 $ 3,482,732 $ <FP<RFP=R= T RRP=<EPIR> T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














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;-1&6-%& J(&$3 <TS=UVSYT> W >VSU=Y W =US<VUS>>G W <TSXGYSXFU W >TSFTYS=VY W <FUSY<GS=<F W <GYST>FSYXF W USXVVS=T= W =TXS=UXS=>= W
!"#$% '()*+ <TS=UVSYT> W ,-./01 2 0/.(-/.,,3 2 (4.531.5)/ 2 >TSFTYS=VY W ()/.1(3.0() 2 <GYST>FSYXF W USXVVS=T= W 045.0/5.0,0 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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8exar (10) 7,716 38,479,979 $ 2,249,230 $ GFRS=VR=FV U 3,901 10,640,034 $ 3,433,299 $ <GRFVTRJJJ U SGRK=>RT>< U
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.














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;-1&6-%& J(&$3 <TS=GXSU== V F>SWX< V =US<<WSFEU V <TSW>GS=GU V F=SUG>SXWW V <EUSFX=SUTU V <GXSEU=S>E> V USWF<STX= V =TGSUX=SWGE V
!"#$% '()*+ <TS=GXSU== V ,-./0( 1 23.((/.,)3 1 (4./-5.253 1 F=SUG>SXWW V ()3.,02.343 1 <GXSEU=S>E> V USWF<STX= V 245.302./5) 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& P(&$3 SQSE> >JQIUSQFSF T =Q=RFQEFR T FEQFRIQSR< T IQJUF <EQF=>QEFE T >QRRSQF=< T <FQES=QFJ< T SFQS<FQR=< T
8exar (10) 7,703 38,397,676 $ 2,246,064 $ FEQFRIQSR< T 3,896 10,623,060 $ 3,447,621 $ <FQES=QFJ< T SFQS<FQR=< T
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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9(:0&C
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;-1&6-%& I(&$3 <FSD<>SUV= W TSDE>SUDV W =ESTV=S==V W <TS>UUSE=X W TXSDV<S>VT W XDSV<VSVTD W <=USV=ESUEF W FS=TXSX=D W <FVSDTTSFTD W
!"##$ % '()* <FSD<>SUV= W +,-(.,/-0 1 2(,+02,220 1 3+,.//,(24 1 TXSDV<S>VT W 4-,030,0+- 1 <=USV=ESUEF W FS=TXSX=D W 350,-++,5+- 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B$&6-%-$ 7$63+11
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;-1&6-%& M(&$3 QN>>H O=NSQONOOQ R <N>Q=NDSO R OON>D>NQGS R GNSSQ <DNHSQNG<= R QNQH>N<HG R <>NOH<NOSQ R ><NDHHNDGQ R
Parrl s (4) 3,668 42,934,443 $ 1,632,094 $ OON>D>NQGS R 3,993 10,893,312 $ 3,386,183 $ <>NOH<NOSQ R ><NDHHNDGQ R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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!"##$ % '()* <WQEVWQVDW U +,-./,-0+ 1 +2,.-2,..3 1 /2,+4+,323 1 RWQVWWQ<S= U 40,554,/.5 1 <=TQEVSQ>=> U >QD<RQRD< U /3-,.05,42/ 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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Parrl s (4) 3,491 41,616,243 $ 1,600,623 $ QHP=<EPIEI S 3,871 10,333,879 $ 3,412,131 $ <RPTEIPDH< S RTP<IQPITI S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B$C0+ 4"-&8
9(:0&C
=D<E?=D<F G+H
2(%$3 I$/
@+A+0:+ JK,:3&
./#$01-(0L
=D<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
=D<< I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
=D<D I(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
=D<E?=D<F K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
=D<E?=D<F K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
=D<E?=D<F
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
=D<E?=D<F K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 =S<D<STU=STV= W =V>SU=FSDTD W =SVEESDTFSX>> W <S>TXSXFTS>X= W EST>DSF<<SVVD W <ES=FESD=TSDT< W ==SUX=SVV=ST>X W <S=>TST<>SX<< W T<SDTDSEFUSV<E W
;-1&6-%& I(&$3 <FST<VSDV= W TS<DDS=>D W =ESFF>S>=T W <TSUTUSE<= W T>SF<>S=TV W ><SU=VSU>> W <T<SFUTSUEE W FSTXVSX=> W <F>SDUUSUEE W
!"##$ % '()* <FST<VSDV= W +,-..,/0. 1 /(,220,0/+ 1 -+,3+3,(-/ 1 T>SF<>S=TV W 0-,3/4,300 1 <T<SFUTSUEE W FSTXVSX=> W -20,.33,3(( 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B$C0+ 4"-&8
9(:0&C
=D<E F,:3&1
G<H>I JK2
.06(33++1
*(,+6$&+
4%+0$6-(
=D<E F,:3&1
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
=D<E F,:3&1
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
=D<E F,:3&1
F33 J:0,1
*(,+6$&+
4%+0$6-(
=D<E 98-3,6+0
G=DDI JK2
.06(33++1
*(,+6$&+
4%+0$6-(
=D<E 98-3,6+0
J+,+6$3 J:0,1
*(,+6$&+
4%+0$6-(
=D<E 98-3,6+0
4&$&+ J:0,1
*(,+6$&+
4%+0$6-(
=D<E 98-3,6+0
F33 J:0,1
*(,+6$&+
4%+0$6-(
=D<E F,:3&1 L
98-3,6+0
F33 J:0,1
*(,+6$&+
4%+0$6-(
4&$&+M-,+ N(&$3 <ODDPOQQ< QOE<ROD>EOQHH S =T=O>>QOTR< S QOTDQOTQPOE>P S RRDO<>T <ORDDOPTROH>P S QETOH=RORQE S =O=ETO>=DOTED S <DO<QQOQTROEPP S
;-1&6-%& N(&$3 ROQEQ PHOQDEOT<R S <OE><ODHR S PROH>QOTRD S PODER <<OD>EO<QP S ROE>PODP< S <EOQQDO=<R S E=O<R>O<ER S
Parrl s (4) 3,767 43,706,913 $ 1,681,033 $ PROH>QOTRD S 4,063 11,086,174 $ 3,684,041 $ <EOQQDO=<R S E=O<R>O<ER S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 129 - kepresentat|ve Iohn L. Dav|s
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 17,S06,681 5 3,134,S92 5 2S,0S3,0SS 5 14,093,682 5 39,146,737 5 82,832,677 5 133,2S2,S31 5 7,447,14S 5 180,071,007 5
!"##$ % '()* 17,S06,681 5 +,-+(,./0 1 0.,2.+,2.. 1 -(,2/+,340 1 39,146,737 5 40,4+0,355 1 133,2S2,S31 5 7,447,14S 5 -42,25-,225 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 129 - kepresentat|ve Iohn L. Dav|s
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| S,831 44,190,627 5 1,699,639 5 4S,890,266 5 4,110 11,208,867 5 S,746,947 5 16,9SS,814 5 62,846,080 5
Parrl s (4) 3,831 44,190,627 $ 1,699,639 $ 4S,890,266 5 4,110 11,208,867 $ 3,746,947 $ 16,9SS,814 5 62,846,080 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B33+0 C3+&%8+6
9(:0&D
E><F?E><G H+I
2(%$3 J$/
@+A+0:+ KB,:3&
./#$01-(0L
E><< 9(:0&D
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
E><< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DQ9(:0&D
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
E><> J(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
J(&$3
N06+-"O:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
E><F?E><G B,:3&1
C+,+6$3 C:0,1
2-"-&+,
4%+0$6-(
E><F?E><G B,:3&1
C+,+6$3 C:0,1
*(,+6$&+
4%+0$6-(
E><F?E><G
B,:3&1 4&$&+
C:0,1 *(,+6$&+
4%+0$6-(
E><F?E><G B,:3&1
C+,+6$3 C:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 ER<><R=SER=TE U ETVRSEGR>=> U ERTFFR>=GRWVV U <RV=WRWG=RVWE U FR=V>RG<<RTT> U <FREGFR>E=R>=< U EERSWERTTER=VW U <REV=R=<VRW<< U =<R>=>RFGSRT<F U
;-1&6-%& J(&$3 <GRWFGRS=S U =R<TSRVVF U ETRETTRE>= U <FRE>GRF>E U =SRFWERW>T U V=RT><R>F> U <=FR=EGRGEE U GRT>GRE=T U <V<RTE=RSWV U
!"##$ % '()* <GRWFGRS=S U +,-./,00( 1 2.,2..,23+ 1 -(,234,(32 1 =SRFWERW>T U 0+,.3-,3(3 1 <=FR=EGRGEE U GRT>GRE=T U -0-,.2+,/50 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B33+0 C3+&%8+6
9(:0&D
E><F B,:3&1
G<=HI CJ2
.06(33++1
*(,+6$&+
4%+0$6-(
E><F B,:3&1
C+,+6$3 C:0,1
*(,+6$&+
4%+0$6-(
E><F B,:3&1
4&$&+ C:0,1
*(,+6$&+
4%+0$6-(
E><F B,:3&1
B33 C:0,1
*(,+6$&+
4%+0$6-(
E><F 98-3,6+0
GE>>I CJ2
.06(33++1
*(,+6$&+
4%+0$6-(
E><F 98-3,6+0
C+,+6$3 C:0,1
*(,+6$&+
4%+0$6-(
E><F 98-3,6+0
4&$&+ C:0,1
*(,+6$&+
4%+0$6-(
E><F 98-3,6+0
B33 C:0,1
*(,+6$&+
4%+0$6-(
E><F B,:3&1 K
98-3,6+0
B33 C:0,1
*(,+6$&+
4%+0$6-(
4&$&+L-,+ M(&$3 <N>>ONPP< PNF<QN>HFNP== R ESENHHPNSQ< R PNS>PNSPONFHO R QQ>N<HS <NQ>>NOSQN=HO R PFSN=EQNQPF R ENEFSNHE>NSF> R <>N<PPNPSQNFOO R
;-1&6-%& M(&$3 QNHPH OONQOPN<S= R <NP<=N=QO R OFNEF>NQOP R ON<O= <<NESSN=>S R QNPS=N=<H R <PN>SENFEH R F=N=Q=N<PO R
Parrl s (4) 3,878 44,347,193 $ 1,713,334 $ OFNEF>NQOP R 4,143 11,299,309 $ 3,793,318 $ <PN>SENFEH R F=N=Q=N<PO R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 131 - kepresentat|ve A|ma A. A||en
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 17,617,27S 5 3,1S4,394 5 2S,211,321 5 14,182,71S 5 39,394,036 5 83,3SS,9S0 5 134,094,318 5 7,494,190 5 181,208,SS7 5
!"##$ % '()* 17,617,27S 5 +,-.(,+/( 0 1.,1--,+1- 0 -(,-21,3-. 0 39,394,036 5 2+,+..,/.4 0 134,094,318 5 7,494,190 5 -2-,142,..3 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 131 - kepresentat|ve A|ma A. A||en
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| S,868 44,469,789 5 1,710,376 5 46,180,16S 5 4,136 11,279,676 5 S,783,2S2 5 17,062,928 5 63,243,093 5
Parrl s (4) 3,868 44,469,789 $ 1,710,376 $ 46,180,16S 5 4,136 11,279,676 $ 3,783,232 $ 17,062,928 5 63,243,093 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& I(&$3 <FS=TDSXUW V =S<<=SW<W V >ESWWFSD<T V <ESDDDS>FT V =WSWWFS>TW V W>S>W=SF<F V <=>S=XTSE>D V FS=TFSFTD V <FWSWFFSX<E V
!"##$ % '()* <FS=TDSXUW V +,--+,.-. / 0(,..1,2-3 / -(,222,013 / =WSWWFS>TW V .0,0.+,1-1 / <=>S=XTSE>D V FS=TFSFTD V -1.,.11,4-( /
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ N(&$3 <ODDPOQQ< QOE<RODHEOQ== S >T>OHHQOTR< S QOTDQOTQPOEHP S RRDO<HT <ORDDOPTRO=HP S QETO=>RORQE S >O>ETOH>DOTED S <DO<QQOQTROEPP S
;-1&6-%& N(&$3 ROQT> P=OHTQOQED S <OEHHO=QR S PRORHEO<=R S PODH= <<O<=PORH> S ROQDHOHED S <EOHP=OPP> S E>OP>TORQH S
Parrl s (4) 3,792 43,897,760 $ 1,688,373 $ PRORHEO<=R S 4,083 11,134,382 $ 3,708,860 $ <EOHP=OPP> S E>OP>TORQH S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ A-" *:6#8B
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;-1&6-%& I(&$3 <FR<TTR<SE U =RDF<RWTV U CERTTDRDTF U <=RV<DRF<S U =VR=WDRFFW U V<R<WSRWC< U <=DRTFFR<VD U FRCSFRWCW U <FWRETTRWWF U
!"##$ % '()* <FR<TTR<SE U +,-./,012 3 4(,11-,-1. 3 /+,2/-,./5 3 =VR=WDRFFW U 2/,/05,04/ 3 <=DRTFFR<VD U FRCSFRWCW U /.0,(11,00. 3
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ A-" *:6#8B
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4&$&+M-,+ N(&$3 <ODDPOQQ< QOE<RODHEOQ== S CTCOHHQOTR< S QOTDQOTQPOEHP S RRDO<HT <ORDDOPTRO=HP S QETO=CRORQE S COCETOHCDOTED S <DO<QQOQTROEPP S
;-1&6-%& N(&$3 ROQ<P P=O=D=O=TH S <OEEROR<R S PPOTEHOT<P S PODCQ <DOTH=OHC= S ROE=<OREP S <EOE<RO=HQ S E<ORHPO=D< S
Parrl s (4) 3,714 43,303,398 $ 1,663,313 $ PPOTEHOT<P S 4,027 10,983,823 $ 3,631,364 $ <EOE<RO=HQ S E<ORHPO=D< S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& H(&$3 <ERT=WRC>D U =R<=SRVV> U CTRDSTR=TT U <>R<<ER>EV U =SRC<CRV== U VCRSECRT=> U <==R>EERT<V U ER>TSRE<S U <VDR=ETRD>= U
!"##$ % '()* <ERT=WRC>D U +,-+.,//( 0 12,3.2,+22 0 -(,--4,(4/ 0 =SRC<CRV== U /1,.41,2+( 0 <==R>EERT<V U ER>TSRE<S U -/3,+42,3(+ 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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4&$&+M-,+ N(&$3 <ODD>OPP< POE<QODHEOP== R CSCOHHPOSQ< R POSDPOSP>OEH> R QQDO<HS <OQDDO>SQO=H> R PESO=CQOQPE R COCESOHCDOSED R <DO<PPOPSQOE>> R
;-1&6-%& N(&$3 QOH>< >>OCEQOC=S R <OPDCOQDS R >QOSEPOP>H R >O<<P <<OCCPOPSC R QOPQEOEQ< R <EOSH>O>>= R ECOSQCO<S< R
Parrl s (4) 3,841 44,263,239 $ 1,702,309 $ >QOSEPOP>H R 4,117 11,227,792 $ 3,736,631 $ <EOSH>O>>= R ECOSQCO<S< R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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9(:0&C
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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;-1&6-%& N(&$3 ROQTR P=OT<TOR>R S <OG>TOE<R S PROGF>O>FF S POF>R <<O<PFO<<> S ROQ<<OGTT S <GO>R<O><Q S GEOPGFOG<Q S
Parrl s (4) 3,793 43,919,383 $ 1,689,213 $ PROGF>O>FF S 4,083 11,140,118 $ 3,711,699 $ <GO>R<O><Q S GEOPGFOG<Q S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& C(&$3 <GSWWVS<FV U =S<W=STE= U DTSDVFS<D= U <FSDD=SWGE U =>STEGSG>= U V=ST>WSWTW U <=FSFV<ST=> U GST<TSV=< U <V<SG=<SVD> U
!"##$ % '()* <GSWWVS<FV U +,-.+,/0+ 1 2/,23(,-2+ 1 -(,22+,.40 1 =>STEGSG>= U 3+,/5.,./. 1 <=FSFV<ST=> U GST<TSV=< U -3-,4+-,325 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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9(:0&B
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DE<F G,:3&1 M
98-3,6+0
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4%+0$6-(
4&$&+N-,+ C(&$3 <OEEPOQQ< QOF<ROEIFOQ== S D>DOIIQO>R< S QO>EQO>QPOFIP S RREO<I> <OREEOP>RO=IP S QF>O=DRORQF S DODF>OIDEO>FE S <EO<QQOQ>ROFPP S
;-1&6-%& C(&$3 ROIIP PPOR>IODEP S <OQ<RO=<F S PFO=<=OR<> S PO<PI <<O=<DODPI S ROQ>>O>RD S <QO<<DODEE S F=OPDROQ<> S
Parrl s (4) 3,884 44,398,204 $ 1,713,316 $ PFO=<=OR<> S 4,148 11,312,248 $ 3,799,932 $ <QO<<DODEE S F=OPDROQ<> S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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;-1&6-%& I(&$3 <FR<XURS=T V SR>FSR=FX V E=RUX=RUWT V <SRW<WRWT= V SWRSWSR=WS V W<RE<FRXXF V <S>RXU=R=F< V FRS><RT=X V <FXRUX>R<<U V
!"##$ % '()* <FR<XURS=T V +,-.+,(./ 0 1(,2/(,234 0 5+,353,34( 0 SWRSWSR=WS V 35,15.,//. 0 <S>RXU=R=F< V FRS><RT=X V 5./,2/-,552 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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98-3,6+0
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4&$&+N-,+ O(&$3 <P>>=PQQ< QPF<RP>IFPQHH S ETEPIIQPTR< S QPT>QPTQ=PFI= S RR>P<IT <PR>>P=TRPHI= S QFTPHERPRQF S EPEFTPIE>PTF> S <>P<QQPQTRPF== S
;-1&6-%& O(&$3 RPQ<Q =HPHETP>H> S <PFFFPR>< S ==PTTRPRHE S =P>H> <>PTT>PHER S RPFH=PITI S <FPFERPEEE S F<PFE>PQR= S
Parrl s (4) 3,717 43,329,030 $ 1,666,301 $ ==PTTRPRHE S 4,030 10,990,323 $ 3,634,898 $ <FPFERPEEE S F<PFE>PQR= S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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!"##$ % '()* <WQERSQWW= U +,--.,+/0 1 +2,-//,(3- 1 42,(.0,4-5 1 REQ=R<QWDE U .-,+32,/(+ 1 <CEQ=<=QRTV U EQ<CDQVW= U 4.+,454,/52 1
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8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
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98-3,6+0
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4&$&+N-,+ A(&$3 <ODD=OPP< POE<QODIEOPHH R CSCOIIPOSQ< R POSDPOSP=OEI= R QQDO<IS <OQDDO=SQOHI= R PESOHCQOQPE R COCESOICDOSED R <DO<PPOPSQOE== R
;-1&6-%& A(&$3 QOQPQ =COCQ=OQDS R <OECQO<PH R =HOIPSOEIH R HOSHD <DOP<POPPQ R QO=SQO<QP R <EOC<COSHC R EDODSCOE<Q R
Parrl s (4) 3,373 42,234,309 $ 1,623,173 $ =HOIPSOEIH R 3,930 10,717,773 $ 3,493,137 $ <EOC<COSHC R EDODSCOE<Q R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 142 - kepresentat|ve naro|d V. Dutton, Ir.
County
2014-2017 New
Loca| 1ax
kevenue (Adu|t
Lxpans|on)
2011 County
Ind|gent
nea|thcare &
Unre|mbursed
Ia|| nea|thcare
Costs
2011 1ota|
nosp|ta| D|str|ct
or C|ty]County
Unre|mbursed
nea|thcare
Lxpend|tures
2010 1ota|
nosp|ta| Char|ty
Care Costs
1ota|
Unre|mbursed
Char|ty Care
Costs for Loca|
Iur|sd|ct|ons &
nosp|ta|s
2014-2017 Adu|ts
Iedera| Iunds
L|m|ted
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2014-2017
Adu|ts State
Iunds Moderate
Scenar|o
2014-2017 Adu|ts
Iedera| Iunds
Lnhanced Scenar|o
Statew|de 1ota| 2,101,392,3S2 5 2S8,927,030 5 2,S44,037,688 5 1,836,673,862 5 4,380,711,SS0 5 14,274,023,031 5 22,962,SS2,386 5 1,283,318,611 5 31,030,479,S14 5
D|str|ct 1ota| 16,040,209 5 2,872,018 5 22,9S4,449 5 12,913,10S 5 3S,867,SS4 5 7S,894,078 5 122,090,440 5 6,823,324 5 164,987,099 5
!"##$ % '()* 16,040,209 5 +,-.+,/0- 1 ++,23(,((2 1 0+,204,0/3 1 3S,867,SS4 5 .3,-2(,/.- 1 122,090,440 5 6,823,324 5 05(,2-.,/22 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






Impact of Med|ca|d Lxtens|on and Loca| Spend|ng for nea|th Care
nouse D|str|ct 142 - kepresentat|ve naro|d V. Dutton, Ir.
County
2016 Adu|ts
<138 IL
Lnro||ees
Moderate
Scenar|o
2016 Adu|ts
Iedera| Iunds
Moderate
Scenar|o
2016 Adu|ts
State Iunds
Moderate
Scenar|o
2016 Adu|ts
A|| Iunds
Moderate
Scenar|o
2016 Ch||dren
<200 IL
Lnro||ees
Moderate
Scenar|o
2016 Ch||dren
Iedera| Iunds
Moderate
Scenar|o
2016 Ch||dren
State Iunds
Moderate
Scenar|o
2016 Ch||dren
A|| Iunds
Moderate
Scenar|o
2016 Adu|ts &
Ch||dren
A|| Iunds
Moderate
Scenar|o
Statew|de 1ota| 1,004,771 7,61S,086,733 5 292,887,9S1 5 7,907,974,684 5 SS0,189 1,S00,49S,384 5 769,32S,S76 5 2,269,820,960 5 10,177,79S,644 5
D|str|ct 1ota| S,342 40,488,93S 5 1,SS7,267 5 42,046,202 5 3,766 10,269,940 5 S,26S,S46 5 1S,S3S,486 5 S7,S81,688 5
Parrl s (4) 3,342 40,488,933 $ 1,337,267 $ 42,046,202 5 3,766 10,269,940 $ 3,263,346 $ 1S,S3S,486 5 S7,S81,688 5
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B0$ 7+60$0,+C 2:0$
9(:0&D
EF<=?EF<G H+I
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@+A+0:+ KB,:3&
./#$01-(0L
EF<< 9(:0&D
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
EF<< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DQ9(:0&D
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
EF<F J(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
J(&$3
N06+-"O:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
EF<=?EF<G B,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
EF<=?EF<G B,:3&1
R+,+6$3 R:0,1
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EF<=?EF<G
B,:3&1 4&$&+
R:0,1 *(,+6$&+
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R+,+6$3 R:0,1
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4&$&+I-,+ J(&$3 ES<F<S>TES>UE V EUWSTEGSF>F V ESU==SF>GSXWW V <SW>XSXG>SWXE V =S>WFSG<<SUUF V <=SEG=SFE>SF>< V EESTXESUUES>WX V <SEW>S><WSX<< V ><SF>FS=GTSU<= V
;-1&6-%& J(&$3 <XSW<<SGU< V >SF<FS<X= V E=SFUWSUGF V <>SU>=SE>< V >GSUTESWF< V GTSU==SXE< V <EGSTX>SFUF V GS<U<SUET V <GESTE>SFUT V
!"##$ % '()* <XSW<<SGU< V +,-.-,./( 0 1(,-23,24- 0 .+,2+(,1+. 0 >GSUTESWF< V 45,2((,/1. 0 <EGSTX>SFUF V GS<U<SUET V .41,51+,-25 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B0$ 7+60$0,+C 2:0$
9(:0&D
EF<G B,:3&1
H<>IJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<G B,:3&1
K+,+6$3 K:0,1
*(,+6$&+
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EF<G B,:3&1
4&$&+ K:0,1
*(,+6$&+
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EF<G B,:3&1
B33 K:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
HEFFJ KL2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
B33 K:0,1
*(,+6$&+
4%+0$6-(
EF<G B,:3&1 M
98-3,6+0
B33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PFF=PQQ< QPG<RPFIGPQ>> S ETEPIIQPTR< S QPTFQPTQ=PGI= S RRFP<IT <PRFFP=TRP>I= S QGTP>ERPRQG S EPEGTPIEFPTGF S <FP<QQPQTRPG== S
;-1&6-%& O(&$3 RPRTT =EP=>GP=QE S <PG>EP<QE S ==PFGIPG== S >PT=Q <FPQG>PTET S RPR<IPIE< S <GPEIEPQRF S GFP>R<P>TR S
Parrl s (4) 3,399 42,436,472 $ 1,632,172 $ ==PFGIPG== S 3,947 10,763,929 $ 3,318,821 $ <GPEIEPQRF S GFP>R<P>TR S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ *$6A B00 C+6+D
9(:0&A
EF<=>EF<G H+I
2(%$3 J$/
?+@+0:+ KB,:3&
./#$01-(0L
EF<< 9(:0&A
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
EF<< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&AQ9(:0&A
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
EF<F J(&$3
7(1#-&$3 98$6-&A
9$6+ 9(1&1
J(&$3
N06+-"O:61+,
98$6-&A 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
EF<=>EF<G B,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
EF<=>EF<G B,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
EF<=>EF<G
B,:3&1 4&$&+
R:0,1 *(,+6$&+
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EF<=>EF<G B,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+I-,+ J(&$3 ES<F<STUESTVE W EVXSUEGSFTF W ESV==SFTGSYXX W <SXTYSYGTSXYE W =STXFSG<<SVVF W <=SEG=SFETSFT< W EESUYESVVESTXY W <SEXTST<XSY<< W T<SFTFS=GUSV<= W
;-1&6-%& J(&$3 <YSEGTSEYF W ESU<TSG=Y W ETSEXGSUVU W <TS<FFSGE< W TYSTXXSYXF W GYSUUYSGVG W <ETSXY=ST<= W YSUEES=Y< W <YGSTX=SEEY W
!"##$ % '()* <YSEGTSEYF W +,-./,0(1 2 +/,+30,-4- 2 ./,.55,0+. 2 TYSTXXSYXF W 01,--1,040 2 <ETSXY=ST<= W YSUEES=Y< W .10,/3(,++1 2
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <== > ?+#6+1+0&$&-@+ *$6A B00 C+6+D
9(:0&A
EF<G B,:3&1
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.06(33++1
*(,+6$&+
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L+,+6$3 L:0,1
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EF<G B,:3&1
4&$&+ L:0,1
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EF<G B,:3&1
B33 L:0,1
*(,+6$&+
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.06(33++1
*(,+6$&+
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L+,+6$3 L:0,1
*(,+6$&+
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4&$&+ L:0,1
*(,+6$&+
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EF<G 98-3,6+0
B33 L:0,1
*(,+6$&+
4%+0$6-(
EF<G B,:3&1 M
98-3,6+0
B33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PFF=PQQ< QPG<RPFJGPQII S ETEPJJQPTR< S QPTFQPTQ=PGJ= S RRFP<JT <PRFFP=TRPIJ= S QGTPIERPRQG S EPEGTPJEFPTGF S <FP<QQPQTRPG== S
;-1&6-%& O(&$3 RP=EF =<PFQQPEFG S <PRQTPJTI S =EPGRQPFTT S IPJEF <FP=<TP<R= S RPI=EPFRF S <RPQG<PEF= S RJP=<JPIFE S
Parrl s (4) 3,420 41,077,206 $ 1,379,893 $ =EPGRQPFTT S 3,820 10,419,134 $ 3,342,030 $ <RPQG<PEF= S RJP=<JPIFE S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 9$6(3 B3A$6$,(
9(:0&C
DE<=?DE<F G+H
2(%$3 I$/
@+A+0:+ JB,:3&
./#$01-(0K
DE<< 9(:0&C
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7+$3&8%$6+ L
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9(1&1
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(6 9-&CP9(:0&C
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
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7(1#-&$3 98$6-&C
9$6+ 9(1&1
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M06+-"N:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
DE<=?DE<F B,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
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DE<=?DE<F B,:3&1
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DE<=?DE<F
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;-1&6-%& I(&$3 <WR>=WRDD> U DRTWDRWD< U DSRWFVR>VV U <SRSDER=F< U SWRTTTRE>T U FVRDVVRDTE U <D>RT=<RTTW U FRESVR>FV U <FER<T<RTE> U
!"##$ % '()* <WR>=WRDD> U +,-.+,.+/ 0 +1,.23,433 0 /1,1+5,(2/ 0 SWRTTTRE>T U 23,+33,+-5 0 <D>RT=<RTTW U FRESVR>FV U /25,/-/,-54 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 9$6(3 B3A$6$,(
9(:0&C
DE<F B,:3&1
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4&$&+ K:0,1
*(,+6$&+
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DE<F B,:3&1
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*(,+6$&+
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.06(33++1
*(,+6$&+
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DE<F 98-3,6+0
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*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
B33 K:0,1
*(,+6$&+
4%+0$6-(
DE<F B,:3&1 M
98-3,6+0
B33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PEE=PQQ< QPF<>PEIFPQHH R DSDPIIQPS>< R QPSEQPSQ=PFI= R >>EP<IS <P>EEP=S>PHI= R QFSPHD>P>QF R DPDFSPIDEPSFE R <EP<QQPQS>PF== R
;-1&6-%& O(&$3 >P><< =<PQFFPDDS R <PFEFPHSH R =HPHQDPFDH R HPII= <EP>SHPSDH R >P=H<PF>Q R <FPED>P>IE R >SPHSIPDEH R
Parrl s (4) 3,311 41,766,229 $ 1,606,393 $ =HPHQDPFDH R 3,884 10,393,923 $ 3,431,637 $ <FPED>P>IE R >SPHSIPDEH R
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B(66-1 *-3+1
9(:0&C
DE<=?DE<F G+H
2(%$3 I$/
@+A+0:+ JK,:3&
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DE<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ M
N06+-"O:61+,
P$-3 7+$3&8%$6+
9(1&1
DE<< I(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CQ9(:0&C
N06+-"O:61+,
7+$3&8%$6+
./#+0,-&:6+1
DE<E I(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
I(&$3
N06+-"O:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 M
7(1#-&$31
DE<=?DE<F K,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
DE<=?DE<F K,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
DE<=?DE<F
K,:3&1 4&$&+
R:0,1 *(,+6$&+
4%+0$6-(
DE<=?DE<F K,:3&1
R+,+6$3 R:0,1
.08$0%+, 4%+0$6-(
4&$&+H-,+ I(&$3 DS<E<STUDSTVD W DVXSUDFSETE W DSV==SETFS>XX W <SXT>S>FTSX>D W =STXESF<<SVVE W <=SDF=SEDTSET< W DDSU>DSVVDSTX> W <SDXTST<XS><< W T<SETES=FUSV<= W
;-1&6-%& I(&$3 <FSV=DS>F= W TS<=<SET> W DVS<E=SV>T W <=S<DDS>VX W TUSDDFSDDD W XTSEEDSUFU W <TTSVD>S=U= W FS=>DS=V> W <XES==<SDDX W
!"##$ % '()* <FSV=DS>F= W +,-(-,.+/ 0 12,-.(,2/+ 0 -(,-11,/23 0 TUSDDFSDDD W 3+,..1,454 0 <TTSVD>S=U= W FS=>DS=V> W -3.,((-,113 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B(66-1 *-3+1
9(:0&C
DE<> F,:3&1
G<HIJ KL2
.06(33++1
*(,+6$&+
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DE<> F,:3&1
K+,+6$3 K:0,1
*(,+6$&+
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DE<> F,:3&1
4&$&+ K:0,1
*(,+6$&+
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DE<> F,:3&1
F33 K:0,1
*(,+6$&+
4%+0$6-(
DE<> 98-3,6+0
GDEEJ KL2
.06(33++1
*(,+6$&+
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DE<> 98-3,6+0
K+,+6$3 K:0,1
*(,+6$&+
4%+0$6-(
DE<> 98-3,6+0
4&$&+ K:0,1
*(,+6$&+
4%+0$6-(
DE<> 98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
DE<> F,:3&1 M
98-3,6+0
F33 K:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PEE=PQQ< QP><RPEI>PQHH S DTDPIIQPTR< S QPTEQPTQ=P>I= S RREP<IT <PREEP=TRPHI= S Q>TPHDRPRQ> S DPD>TPIDEPT>E S <EP<QQPQTRP>== S
;-1&6-%& O(&$3 RPI=H ==PDI<P=I< S <PQEHP<H= S =RPTI=P><R S =P<<I <<PDH<PT<D S RPQRIPQ>H S <>PTTEP>QR S >DPTQRPDTE S
Parrl s (4) 3,843 44,281,481 $ 1,703,134 $ =RPTI=P><R S 4,118 11,231,912 $ 3,738,763 $ <>PTTEP>QR S >DPTQRPDTE S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B$60+& 9(3+"$0
9(:0&C
DE<=?DE<> F+G
2(%$3 H$/
@+A+0:+ IJ,:3&
./#$01-(0K
DE<< 9(:0&C
!0,-5+0&
7+$3&8%$6+ L
M06+-"N:61+,
O$-3 7+$3&8%$6+
9(1&1
DE<< H(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&CP9(:0&C
M06+-"N:61+,
7+$3&8%$6+
./#+0,-&:6+1
DE<E H(&$3
7(1#-&$3 98$6-&C
9$6+ 9(1&1
H(&$3
M06+-"N:61+,
98$6-&C 9$6+
9(1&1 )(6 2(%$3
O:6-1,-%&-(01 L
7(1#-&$31
DE<=?DE<> J,:3&1
Q+,+6$3 Q:0,1
2-"-&+,
4%+0$6-(
DE<=?DE<> J,:3&1
Q+,+6$3 Q:0,1
*(,+6$&+
4%+0$6-(
DE<=?DE<>
J,:3&1 4&$&+
Q:0,1 *(,+6$&+
4%+0$6-(
DE<=?DE<> J,:3&1
Q+,+6$3 Q:0,1
.08$0%+, 4%+0$6-(
4&$&+G-,+ H(&$3 DR<E<RSTDRSUD V DUWRTD>RESE V DRU==RES>RXWW V <RWSXRX>SRWXD V =RSWER><<RUUE V <=RD>=REDSRES< V DDRTXDRUUDRSWX V <RDWSRS<WRX<< V S<RESER=>TRU<= V
;-1&6-%& H(&$3 <>RXWDRDD= V SR<XXREDS V DURSE=RDXX V <=RDSUREED V STRUSTRDXW V WSRXXSRDU= V <S=RUWWRX>X V >RUD<RW<T V <W<RW>XRXEW V
!"##$ % '()* <>RXWDRDD= V +,-..,/0+ 1 02,+/(,0.. 1 -(,0+2,//0 1 STRUSTRDXW V 3+,..+,02( 1 <S=RUWWRX>X V >RUD<RW<T V -3-,34.,./3 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B$60+& 9(3+"$0
9(:0&C
DE<F G,:3&1
H<IJK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1
G33 L:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
HDEEK LM2
.06(33++1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
L+,+6$3 L:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
4&$&+ L:0,1
*(,+6$&+
4%+0$6-(
DE<F 98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
DE<F G,:3&1 N
98-3,6+0
G33 L:0,1
*(,+6$&+
4%+0$6-(
4&$&+O-,+ P(&$3 <QEE=Q>>< >QF<RQEJFQ>II S DTDQJJ>QTR< S >QTE>QT>=QFJ= S RREQ<JT <QREEQ=TRQIJ= S >FTQIDRQR>F S DQDFTQJDEQTFE S <EQ<>>Q>TRQF== S
;-1&6-%& P(&$3 RQJJT ==QFIIQ>II S <Q><FQFJD S =FQIREQ=<R S =Q<R< <<QID<QDFE S RQJE=QR>I S <>Q<DRQJII S FIQ=>FQD=J S
Parrl s (4) 3,889 44,633,733 $ 1,716,682 $ =FQIREQ=<R S 4,131 11,321,260 $ 3,804,373 $ <>Q<DRQJII S FIQ=>FQD=J S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B+11-%$ C$66$6
9(:0&D
EF<=?EF<G H+I
2(%$3 J$/
@+A+0:+ KL,:3&
./#$01-(0M
EF<< 9(:0&D
!0,-5+0&
7+$3&8%$6+ N
O06+-"P:61+,
B$-3 7+$3&8%$6+
9(1&1
EF<< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DQ9(:0&D
O06+-"P:61+,
7+$3&8%$6+
./#+0,-&:6+1
EF<F J(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
J(&$3
O06+-"P:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
B:6-1,-%&-(01 N
7(1#-&$31
EF<=?EF<G L,:3&1
C+,+6$3 C:0,1
2-"-&+,
4%+0$6-(
EF<=?EF<G L,:3&1
C+,+6$3 C:0,1
*(,+6$&+
4%+0$6-(
EF<=?EF<G
L,:3&1 4&$&+
C:0,1 *(,+6$&+
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;-1&6-%& J(&$3 <GR<GSRET< V SRFG=R>T> V E=RUGURTUU V <SR>EURE>> V S>R=F<RE=S V ><REUURE=G V <SFRG<=RTEG V GRSFURSEU V <GWRW=<R><E V
!"##$ % '()* <GR<GSRET< V +,-.(,/0/ 1 2(,3.3,033 1 4+,/23,2// 1 S>R=F<RE=S V /4,233,2(. 1 <SFRG<=RTEG V GRSFURSEU V 4.5,5(4,/42 1
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ B+11-%$ C$66$6
9(:0&D
EF<G H,:3&1
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.06(33++1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1
C+,+6$3 C:0,1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1
4&$&+ C:0,1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1
H33 C:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
IEFFK CL2
.06(33++1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
C+,+6$3 C:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
4&$&+ C:0,1
*(,+6$&+
4%+0$6-(
EF<G 98-3,6+0
H33 C:0,1
*(,+6$&+
4%+0$6-(
EF<G H,:3&1 M
98-3,6+0
H33 C:0,1
*(,+6$&+
4%+0$6-(
4&$&+N-,+ O(&$3 <PFF=PQQ< QPG<RPF>GPQJJ S ETEP>>QPTR< S QPTFQPTQ=PG>= S RRFP<>T <PRFFP=TRPJ>= S QGTPJERPRQG S EPEGTP>EFPTGF S <FP<QQPQTRPG== S
;-1&6-%& O(&$3 RPQEF =JPJ=TPFQT S <PGGQPEQE S =RPF<GPJRE S =PFJE <FPTTRP=<F S RPGJQPRFR S <GPGJEPT<R S G<PG=TPEGQ S
Parrl s (4) 3,720 43,349,079 $ 1,667,272 $ =RPF<GPJRE S 4,032 10,993,410 $ 3,637,303 $ <GPGJEPT<R S G<PG=TPEGQ S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











!"#$%& () *+,-%$-, ./&+01-(0 $0, 2(%$3 4#+0,-05 )(6 7+$3&8 9$6+
7(:1+ ;-1&6-%& <=> ? @+#6+1+0&$&-A+ 7:B+6& C(
9(:0&D
EF<=?EF<G H+I
2(%$3 J$/
@+A+0:+ KL,:3&
./#$01-(0M
EF<< 9(:0&D
!0,-5+0&
7+$3&8%$6+ N
O06+-"B:61+,
P$-3 7+$3&8%$6+
9(1&1
EF<< J(&$3
7(1#-&$3 ;-1&6-%&
(6 9-&DQ9(:0&D
O06+-"B:61+,
7+$3&8%$6+
./#+0,-&:6+1
EF<F J(&$3
7(1#-&$3 98$6-&D
9$6+ 9(1&1
J(&$3
O06+-"B:61+,
98$6-&D 9$6+
9(1&1 )(6 2(%$3
P:6-1,-%&-(01 N
7(1#-&$31
EF<=?EF<G L,:3&1
R+,+6$3 R:0,1
2-"-&+,
4%+0$6-(
EF<=?EF<G L,:3&1
R+,+6$3 R:0,1
*(,+6$&+
4%+0$6-(
EF<=?EF<G
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R:0,1 *(,+6$&+
4%+0$6-(
EF<=?EF<G L,:3&1
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4&$&+I-,+ J(&$3 ES<F<ST>ESTUE V EUWS>EGSFTF V ESU==SFTGSXWW V <SWTXSXGTSWXE V =STWFSG<<SUUF V <=SEG=SFETSFT< V EES>XESUUESTWX V <SEWTST<WSX<< V T<SFTFS=G>SU<= V
;-1&6-%& J(&$3 <GSEWESXG> V TSF>=S=W= V E=SGTES=>= V <TS><TSTUF V TWSX=USW== V W<SGGESW<E V <T<SU=GSUTF V GSTU<SWUG V <GGSGXXS>UE V
!"##$ % '()* <GSEWESXG> V +,-.(,(/( 0 1(,2+1,(.( 0 3+,.3+,+4- 0 TWSX=USW== V /3,221,/31 0 <T<SU=GSUTF V GSTU<SWUG V 322,255,.41 0
!"!#$%&% ($ (&##$ )!*&#+," -,"%.#+&"/
!"#$%&'%( *$&'+,'& #- .-/01%+-2$ 3&45#6 7'55
8,9$ .-+,5 :," ;-55,<6 ,%& =<-/ #>$ !+-%-2?
Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.











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Download this one-pager at www.texasimpact.org/Local-Taxpayers-Win-With-Medicaid
Download the Iull report at www.mhm.org
Download the executive summary at www.texasimpact.org
For more information about the report, Smart, Affordable and Fair call Texas Impact at 512/472-3903 or
email medicaidreporttexasimpact.org






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Parrl s (4) 3,630 42,822,224 $ 1,647,009 $ QQPQETPDHH S 3,983 10,861,774 $ 3,368,988 $ <EPQH>PRED S E>PITTPTT= S
noLe: new local Lax revenues are an allocaLlon of Lhe sLaLewlde esLlmaLe based on Lhe counLy share of sLaLe personal lncome and furLher allocaLed ln parLlal counLles accordlng Lo Lhe share of counLy
populaLlon. varlaLlons ln personal lncome or Lhe concenLraLlon of dlrecL healLh care spendlng ln parLs of counLles could alLer Lhese allocaLlons. 8emalnlng columns reflecL allocaLlons of sLaLewlde
esLlmaLes accordlng Lo Lhe counLy share of adulLs below 138 lL or chlldren below 200 lL, as appllcable, and furLher allocaLed for parLlal counLles accordlng Lo Lhe share of Lhe counLy's LoLal
populaLlon. varlaLlons ln percenLages of adulLs below 138 lL and chlldren below 200 lL could alLer Lhese esLlmaLes. PosplLal charlLy cosL daLa exclude cerLaln hosplLals, such as Lhose exempL
from reporLlng, hosplLals LhaL reporL by sysLem, and oLhers, resulLlng ln a conservaLlve esLlmaLe of unrelmbursed charlLy cosLs. Medlcald exLenslon Lo adulLs would noL relleve all local unrelmbursed
cosLs due Lo lnellglble adulLs, such as undocumenLed lmmlgranLs, people served wlLh lncomes above 138 lL or healLh care for lncarceraLed adulLs oLher Lhan lnpaLlenL hosplLal sLays. 2016 ls Lhe flrsL
full year of lmplemenLaLlon, Lhe federal maLch raLe falls Lo 93 percenL ln 2017 and Lo 90 percenL by 2020. lor full counLy-level daLa, see Appendlx C, and for furLher noLes and cauLlons ln lnLerpreLlng
Lhese daLa, see Appendlx A, ln "SmarL, Affordable and lalr: Why 1exas Should LxLend Medlcald Lo Low-lncome AdulLs," aL
hLLp://www.mhm.org/lmages/sLorles/advocacy_and_publlc_pollcy/SmarL20Affordable20and20lalr_lnL_luLL.pdf.

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